Organization
CEDAR VALLEY PODIATRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROXANNE MASTELLER (OFFICE MANAGER)
(319) 277-4508
Entity
Organization
Contact information
Practice address
4508 CHADWICK RD, CEDAR FALLS, IA 50613-7958
(319) 277-4508
(319) 277-8908
Mailing address
4508 CHADWICK RD, CEDAR FALLS, IA 50613-7958
(319) 277-4508
(319) 277-8908
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
213ES0131X
Foot Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0469726
—
IA
01
—
I7692
MEDICARE GROUP NUMBER
IA
Enumeration date
07/03/2006
Last updated
02/11/2020
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