Individual
NICOLE RAE BANDSTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 E 10TH ST, PELLA, IA 50219-2002
(641) 278-5005
Mailing address
PO BOX 126, NEW SHARON, IA 50207-0126
(641) 278-5005
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
006340
IA
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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