| NPI | 1174139158 |
|---|---|
| Doing Business As | PRIMARY HEALTH CARE-SOUTH SIDE CLINIC |
| Entity Type | Organization |
| Authorized Contact | KELLY ANN HUNTSMAN Chief Executive Officer 515-248-1441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2020-09-16 |