Individual
LOREN NYDEGGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 1ST ST SW, MOUNT VERNON, IA 52314-1098
(319) 895-4573
Mailing address
204 OAK RIDGE DR SE, MOUNT VERNON, IA 52314-1585
(319) 621-2602
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000724
IA
Other
Enumeration date
03/28/2024
Last updated
03/28/2024
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