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Individual

MRS. TINA LEE SHADE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MT

Contact information

Practice address
2255 JFK RD, DUBUQUE, IA 52002-2846
(563) 583-3629
Mailing address
2255 JFK RD, DUBUQUE, IA 52002-2846
(563) 583-3629

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
02378
IA

Other

Enumeration date
01/08/2013
Last updated
11/14/2018
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