Individual
LISA MARIE VANWIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2350 OAKDALE BLVD, CORALVILLE, IA 52241-9702
(515) 491-7865
Mailing address
1506 JERSEY RIDGE RD, DAVENPORT, IA 52803-3737
(515) 491-7865
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
094540
IA
Other
Enumeration date
02/22/2019
Last updated
02/22/2019
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