Individual
MRS. CANDACE LEE DIERCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1844 W RIDGEWAY AVE, WATERLOO, IA 50701-4546
(319) 235-5999
Mailing address
1844 W RIDGEWAY AVE, WATERLOO, IA 50701-4546
(319) 235-5999
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
01/20/2012
Last updated
01/20/2012
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