Provider Demographics
NPI:1154606218
Name:VOS, CONNIE LOUISE (PTA)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:LOUISE
Last Name:VOS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 BOS LANDEN WEG
Mailing Address - Street 2:
Mailing Address - City:PELLA
Mailing Address - State:IA
Mailing Address - Zip Code:50219-7903
Mailing Address - Country:US
Mailing Address - Phone:641-780-6070
Mailing Address - Fax:
Practice Address - Street 1:607 BOS LANDEN WEG
Practice Address - Street 2:
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219-7903
Practice Address - Country:US
Practice Address - Phone:641-780-6070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0367225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant