Individual
MRS. JULIE A LAUTENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
405 MONROE ST, PELLA, IA 50219-1189
(641) 628-3832
(641) 621-2335
Mailing address
405 MONROE ST, PELLA, IA 50219-1189
(641) 628-3832
(641) 621-2335
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001511
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71188
WELLMARK
IA
Enumeration date
02/10/2006
Last updated
10/20/2014
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