Provider Demographics
NPI:1275199457
Name:FINN, MASON
Entity Type:Individual
Prefix:
First Name:MASON
Middle Name:
Last Name:FINN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1422 WALTON DR UNIT 202
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50014-5554
Mailing Address - Country:US
Mailing Address - Phone:515-520-2121
Mailing Address - Fax:
Practice Address - Street 1:312 GRETTEN ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:IA
Practice Address - Zip Code:50105-1002
Practice Address - Country:US
Practice Address - Phone:515-520-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IA1073302255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program