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NPI 1306144464

NPI 1306144464 : ANDREW GLEN PICK DO : SPENCER, IA

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General NPI Number Information
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    NPI Number           |    1306144464
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    Entity Type          |    Individual 
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    Provider Name        |    ANDREW GLEN PICK DO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/14/2011
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    Last Update Date     |    07/06/2016
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Provider Practice Location Address
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    Address Line         |    1200 1ST AVE E STE C
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    City                 |    SPENCER
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    State                |    IA
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    Zip                  |    51301-4342
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    Country              |    US
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    Telephone            |    712-262-7511
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    Fax                  |    712-262-3658
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Provider Business Mailing Address
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    Address Line         |    1200 1ST AVE E STE C
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    City                 |    SPENCER
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    State                |    IA
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    Zip                  |    51301-4342
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    Country              |    US
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    Telephone            |    712-262-7511
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    Fax                  |    712-262-3658
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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        |    207X00000X
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    Taxonomy Name        |    Orthopaedic Surgery Physician
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    License Number       |    04833
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    License Number State |    IA
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