Individual
MRS. DEANNA L AXTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
700 WAVERLY RD, DAVENPORT, IA 52804-4317
(563) 324-1651
Mailing address
700 WAVERLY RD, DAVENPORT, IA 52804-4317
(563) 324-1651
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
01017
IA
Other
Enumeration date
09/26/2013
Last updated
09/26/2013
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