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Individual

JUDY JICINSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
625 32ND AVE SW, CEDAR RAPIDS, IA 52404-3947
(319) 363-2901
(319) 363-2903
Mailing address
1585 EAGLE VIEW CT NW, SWISHER, IA 52338-9437
(319) 981-2276
(319) 363-2903

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
02851
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0429027
IA
01
30406
WELLMARK BCBS
IA
01
F232553
MIDLANDS CHOICE
IA
01
P00062328
RAILROAD MEDICARE
IA
Enumeration date
07/31/2006
Last updated
07/08/2007
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