Healthcare Provider Details

I. General information

NPI: 1952496648
Provider Name (Legal Business Name): RITA MARIE DHONDT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 HIGHWAY 6 W
IOWA CITY IA
52246-2292
US

IV. Provider business mailing address

2930 260TH ST
WILLIAMSBURG IA
52361-8636
US

V. Phone/Fax

Practice location:
  • Phone: 319-338-0581
  • Fax: 319-887-4923
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number833
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: