MEDICARE: MRS. AMY TERESE VAASSEN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	06268	IA

General Provider Information

NPI Number	:	1811999469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMY TERESE VAASSEN DC

Provider Business Mailing Address
First Line	:	3338 CENTER GROVE DR STE 2
Second Line	:
City	:	DUBUQUE
State	:	IA
Zip	:	52003-5225
Country	:	US
Telephone Number	:	563-585-2225
Fax Number	:	563-585-2229

Provider Business Practice Location Address
First Line	:	3338 CENTER GROVE DR STE 2
Second Line	:
City	:	DUBUQUE
State	:	IA
Zip	:	52003-5225
Country	:	US
Telephone Number	:	563-585-2225
Fax Number	:	563-585-2229

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	05/04/2009

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