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Individual

KATIE ALISSA DEJONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
200 HAWKINS DR, GH-C43, IOWA CITY, IA 52242-1007
(313) 333-8056
Mailing address
19 FOREST GLN, IOWA CITY, IA 52245-1625
(313) 333-8056

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
R-9304
IA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/14/2011
Last updated
07/07/2011
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