Individual
JESSICA LYNN WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
40 1ST ST SE, WAUKON, IA 52172-2022
(563) 568-3411
Mailing address
2555 ENGLISH BENCH RD, DORCHESTER, IA 52140-7542
(563) 568-3060
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
00758
IA
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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