| NPI | 1043375132 |
|---|---|
| Doing Business As | MARENGO FAMILY MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | BARRY G GOETTSCH CEO 319-642-5543 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 02712) |
| 207R00000X Internal Medicine (Licence: IA 38260) | |
| 213E00000X Podiatrist (Licence: IA 00701) | |
| 363L00000X Nurse Practitioner (Licence: IA 104766) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA 109633) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-01-21 |