| NPI | 1073516795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA MAE MASAKOWSKI Business Office Manager 563-359-1716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2011-11-30 |