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1083760755
MYRNA RAE VAN DE WALLE
CLEAR LAKE, IA
NPI
1083760755
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: IA 00694)
Enumeration Date
2007-01-26
Last Update Date
2007-07-08
Business Address
Mrs. MYRNA RAE VAN DE WALLE Physical Therapist
9184 265TH ST SUITE B
CLEAR LAKE, IA 50428-8507
Phone number: 641-357-6112
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Mailing Address
Mrs. MYRNA RAE VAN DE WALLE Physical Therapist
609 S TENNESSEE PL
MASON CITY, IA 50401-5358
Phone number: 641-424-6042
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