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Individual

NICHOLAS J GOETSCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3421 W 9TH ST, WATERLOO, IA 50702-5401
(319) 272-8000
Mailing address
3421 W 9TH ST, WATERLOO, IA 50702-5401
(319) 272-8000

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3649
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0456830
IA
05
1740287614
IA
01
P00469847
RR MEDICARE
IA
Enumeration date
07/06/2005
Last updated
09/08/2016
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