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General NPI Number Information
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NPI Number | 1033573357
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Entity Type | Individual
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Provider Name | SHARON DIANE FELD EDD, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 04/12/2016
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 1450 ALTA VISTA ST
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City | DUBUQUE
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State | IA
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Zip | 52001-4399
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Country | US
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Telephone | 563-588-7211
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Fax |
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Provider Business Mailing Address
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Address Line | 430 LOWELL ST
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City | DUBUQUE
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State | IA
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Zip | 52001-4440
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Country | US
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Telephone | 515-664-7471
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 096.003827
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License Number State | IL
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