Individual
OLYMPIA NIEDERECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1650 1ST AVE NE, CEDAR RAPIDS, IA 52402-5431
(319) 362-3937
(319) 362-2900
Mailing address
923 HARLOCKE ST, IOWA CITY, IA 52246-5127
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136259
—
IA
01
—
0380170001
DMERC
IA
01
—
13625
BCBS
IA
Enumeration date
11/01/2006
Last updated
07/08/2007
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