Provider Demographics
NPI:1790331700
Name:DEHLI, HERBERT RUDOLPH
Entity Type:Individual
Prefix:MR
First Name:HERBERT
Middle Name:RUDOLPH
Last Name:DEHLI
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 1:2133 SWEET RIDGE DR.
Mailing Address - Street 2:
Mailing Address - City:HARPERS FERRY
Mailing Address - State:IA
Mailing Address - Zip Code:52146-7557
Mailing Address - Country:US
Mailing Address - Phone:563-586-2313
Mailing Address - Fax:
Practice Address - Street 1:2133 SWEET RIDGE DR.
Practice Address - Street 2:
Practice Address - City:HARPERS FERRY
Practice Address - State:IA
Practice Address - Zip Code:52146-7557
Practice Address - Country:US
Practice Address - Phone:563-586-2313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider