Individual
SOPHIE POULIOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 PLEASANT ST STE 608, DES MOINES, IA 50309-1418
(515) 875-9560
(515) 875-9561
Mailing address
PO BOX 424, DES MOINES, IA 50302-0424
(515) 875-9255
(515) 875-9223
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
122671
IA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
09/07/2022
Last updated
02/20/2024
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