Provider Information for 1073024600
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LINDSAY M DEMARLIE LISW
Sex: Female
NPI: 1073024600
Last Updated: 2020-04-08
Certification Date: 2020-04-08
Certification Date: 2020-04-08
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1073024600 | ||||||||
| Enumeration Date | 2017-10-23 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1320 19TH AVE NW CLINTON, IA 52732-2752 United States Phone: 563-243-5633 | Fax:563-243-9567 | ||||||||
| Primary Practice Address | 1320 19TH AVE NW CLINTON, IA 52732-2752 United States Phone: 563-243-5633 | Fax:563-243-9567 | ||||||||
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