Healthcare Provider Details

I. General information

NPI: 1811999469
Provider Name (Legal Business Name): AMY TERESE VAASSEN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 05/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3338 CENTER GROVE DR STE 2
DUBUQUE IA
52003-5225
US

IV. Provider business mailing address

3338 CENTER GROVE DR STE 2
DUBUQUE IA
52003-5225
US

V. Phone/Fax

Practice location:
  • Phone: 563-585-2225
  • Fax: 563-585-2229
Mailing address:
  • Phone: 563-585-2225
  • Fax: 563-585-2229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number06268
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: