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General NPI Number Information
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NPI Number | 1558568469
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Entity Type | Individual
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Provider Name | MEGAN MICHELLE ADAMS RIECK PHD
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Gender | Female
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 12/29/2016
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Provider Practice Location Address
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Address Line | 1026 A AVE NE ST LUKE'S HOSPITAL PM & R DEPT
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City | CEDAR RAPIDS
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State | IA
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Zip | 52402
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Country | US
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Telephone | 319-369-7331
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Fax | 319-369-8251
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Provider Business Mailing Address
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Address Line | 1026 A AVE NE ST LUKE'S HOSPITAL PHYSICAL MEDICINE AND REHABILITATION
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City | CEDAR RAPIDS
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State | IA
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Zip | 52402-5036
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Country | US
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Telephone | 319-369-7331
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Fax | 319-369-8251
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 074683
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License Number State | IA
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