Individual
MEGAN R GRODAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1351 W MAIN ST, LAKE CITY, IA 51449-1585
(712) 464-7907
(712) 464-7412
Mailing address
1301 W MAIN ST, PO BOX 114, LAKE CITY, IA 51449-1585
(712) 464-3171
(712) 464-3269
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
079586
IA
Other
Enumeration date
09/08/2015
Last updated
09/08/2015
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