Individual
AMANDA J DYVIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A
Contact information
Practice address
1301 PENNSYLVANIA AVE, STE 417, DES MOINES, IA 50316-2350
(515) 263-5684
Mailing address
1575 SE OLSON DR, WAUKEE, IA 50263-8260
(515) 987-8991
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001439
IA
Other
Enumeration date
11/28/2006
Last updated
02/19/2008
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