Individual
KATIE JOANNE EATOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
758 216TH DR, OGDEN, IA 50212-7520
(515) 275-4003
(515) 275-4122
Mailing address
2213 GRAND AVE, DES MOINES, IA 50312-5305
(515) 237-3974
(515) 883-2692
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
001982
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IN PROCESS
—
IA
Enumeration date
03/27/2012
Last updated
03/27/2012
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