Individual
CHRISTOPHER R VONSTADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EDD
Contact information
Practice address
320 WEST CHERRY STREET, NORTH LIBERTY, IA 52317
(319) 626-3300
(319) 626-3084
Mailing address
320 WEST CHERRY STREET, NORTH LIBERTY, IA 52317
(319) 626-3300
(319) 626-3084
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
00821
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1160317
—
IA
01
—
40
MIDLANDS CHOICE
IA
01
—
680015960
RAILROAD MEDICARE
IA
Enumeration date
08/08/2006
Last updated
10/24/2013
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