Individual
DALE NYSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
645 S MAIN AVE, SIOUX CENTER, IA 51250-1347
(712) 722-2609
(712) 722-8392
Mailing address
645 S MAIN AVE, SIOUX CENTER, IA 51250-1347
(712) 722-2609
(712) 722-8392
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21738
IA
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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