Healthcare Provider Details

I. General information

NPI: 1326002718
Provider Name (Legal Business Name): BRUCE LLOYD PLAKKE PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 KIMBALL AVE STE 300
WATERLOO IA
50702
US

IV. Provider business mailing address

2055 KIMBALL AVE STE 300
WATERLOO IA
50702
US

V. Phone/Fax

Practice location:
  • Phone: 319-272-2500
  • Fax: 319-272-2503
Mailing address:
  • Phone: 319-272-2500
  • Fax: 319-272-2503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number115
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number115
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: