Individual
DOUGLAS SIEMEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2170 DELTA AVE, WEST LIBERTY, IA 52776-9012
(563) 212-5593
Mailing address
2170 DELTA AVE, WEST LIBERTY, IA 52776-9012
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5076
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5076
IOWA THERAPY LICENSE
IA
Enumeration date
12/14/2015
Last updated
12/14/2015
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