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1992758163
MITCHELL HERMAN FONLEY
WATERLOO, IA
NPI
1992758163
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IA 03651)
Enumeration Date
2006-05-18
Last Update Date
2022-02-04
Business Address
MITCHELL HERMAN FONLEY PT
1631 LOGAN AVE
WATERLOO, IA 50703-1237
Phone number: 319-232-2630
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Mailing Address
MITCHELL HERMAN FONLEY PT
PO BOX 2758
WATERLOO, IA 50704-2758
Phone number: 319-833-5900
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