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Individual

DR. AMANDA DIANE FRIEMEL PANEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.C.,FIAMA,DIPL.AC

Contact information

Practice address
24609 VALLEY DR, PLEASANT VALLEY, IA 52767
(563) 888-1978
Mailing address
24609 VALLEY DR, PLEASANT VALLEY, IA 52767
(563) 888-1978

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038-010735
IL
111N00000X
Chiropractor
Primary
06633
IA
111N00000X
Chiropractor
4818
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0201796
IA
01
1477566404
GROUP NPI
IA
01
1871777474
INDIVIDUAL NPI
IA
01
72004
WELLMARK
IA
01
I11500
MEDICARE GROUP
IA
Enumeration date
12/19/2007
Last updated
11/09/2015
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