Individual
AMBER L COLLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1803 C AVE, VINTON, IA 52349-1691
(319) 472-2304
(319) 472-4579
Mailing address
1803 C AVE, VINTON, IA 52349-1691
(515) 471-9372
(515) 471-9319
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001495
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PO00055841
RR MEDICARE
IA
Enumeration date
12/29/2005
Last updated
10/25/2011
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