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Individual

KENT DEXTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1377 11TH ST NW, CLINTON, IA 52732-5068
(563) 241-4230
(563) 519-4235
Mailing address
1377 11TH ST NW, CLINTON, IA 52732-5068
(563) 241-4230

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
01532
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0665711
IA
01
55986
BLUE CROSS BLUE SHIELD
IA
01
I20282
MEDICARE
IA
Enumeration date
06/14/2007
Last updated
12/27/2007
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