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General NPI Number Information
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NPI Number | 1508433038
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Entity Type | Individual
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Provider Name | AMELIA ROSE DANNENMUELLER ATC
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Gender | Female
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Dates
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Enumeration Date | 06/04/2021
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Last Update Date | 06/04/2021
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Provider Practice Location Address
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Address Line | 2000 UNIVERSITY AVE
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City | DUBUQUE
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State | IA
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Zip | 52001-5099
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Country | US
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Telephone | 715-222-1648
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Fax |
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Provider Business Mailing Address
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Address Line | 2394 81ST AVE
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City | OSCEOLA
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State | WI
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Zip | 54020-4348
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Country | US
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Telephone | 715-222-1648
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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 | 108908
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License Number State | IA
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