Individual
MRS. SANDRA LOUISE DITTMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
67464 250TH ST, COLO, IA 50056-8614
(641) 377-2922
Mailing address
67464 250TH ST, COLO, IA 50056-8614
(641) 377-2922
Taxonomy
Speciality
Code
Description
License number
State
261QM3000X
Medically Fragile Infants and Children Day Care
Primary
4285081
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0256727
—
IA
Enumeration date
04/18/2007
Last updated
07/09/2007
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