Individual
MACY DIELEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
718 STORY ST, BOONE, IA 50036-2834
(515) 432-2020
(515) 432-8482
Mailing address
1215 DUFF AVE, AMES, IA 50010-5469
(515) 239-4400
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
083098
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1219526
—
IA
Enumeration date
07/21/2016
Last updated
12/28/2020
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