Individual
DR. DAVID NYSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
405 S CLARK ST, SUITE # 230, CARROLL, IA 51401-3065
(712) 792-2222
(712) 792-3875
Mailing address
405 S CLARK ST STE 100, CARROLL, IA 51401-3047
(712) 792-2222
(712) 792-3875
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3647
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0469395
—
IA
Enumeration date
02/15/2006
Last updated
10/09/2013
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