Individual
BLYTHE D WALTERSDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1610 W TOWNLINE ST, SUITE 1, CRESTON, IA 50801-1066
(641) 782-2131
(641) 782-6425
Mailing address
1610 W TOWNLINE ST, SUITE 1, CRESTON, IA 50801-1066
(641) 782-2131
(641) 782-6425
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001293
IA
Other
Enumeration date
09/27/2005
Last updated
07/01/2011
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