| NPI | 1003807835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL P MOHAN Board Chair 515-270-5240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2005-11-01 |
| Last Update Date | 2010-01-27 |