Individual
KIRK W NEUSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1228 8TH ST STE 105, WEST DES MOINES, IA 50265-2624
(515) 221-9330
Mailing address
5005 BROOKVIEW DR, WEST DES MOINES, IA 50265-2734
(515) 221-9330
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
446
IA
213ES0000X
Sports Medicine Podiatrist
446
IA
213ES0103X
Foot & Ankle Surgery Podiatrist
446
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0083139
—
IA
Enumeration date
01/02/2007
Last updated
12/28/2010
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