BLAKE TIEDTKE

CEDAR RAPIDS, IA
NPI1922248566
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208100000X Physical Medicine & Rehabilitation
(Licence: IA  004341)
Enumeration Date2009-02-23
Last Update Date2020-03-04
Business Address
BLAKE TIEDTKE DPT
645 32ND AVE SW STE A
CEDAR RAPIDS, IA 52404-3907
Phone number: 319-363-2901
Mailing Address
BLAKE TIEDTKE DPT
3290 RIDGEWAY DR STE 3
CORALVILLE, IA 52241
Phone number: 319-665-2630
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