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General NPI Number Information
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NPI Number | 1528345022
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Entity Type | Individual
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Provider Name | JESSICA ANNE VANDE HOEF DPT
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Gender | Female
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Dates
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Enumeration Date | 11/11/2011
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Last Update Date | 11/11/2011
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Provider Practice Location Address
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Address Line | 147 S MAIN AVE
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City | SIOUX CENTER
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State | IA
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Zip | 51250-1535
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Country | US
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Telephone | 712-722-1902
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Fax |
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Provider Business Mailing Address
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Address Line | 227 20TH ST SE
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City | SIOUX CENTER
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State | IA
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Zip | 51250-2605
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Country | US
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Telephone | 712-541-9544
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 004241
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License Number State | IA
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