NPI | 1124177407 |
---|---|
Doing Business As | PRIMARY HEALTH CARE-EAST SIDE CLINIC |
Entity Type | Organization |
Authorized Contact | KELLY HUNTSMAN Chief Executive Officer 515-248-1441 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: IA NA) |
Enumeration Date | 2007-01-09 |
Last Update Date | 2016-09-23 |