NPI | 1174607709 |
---|---|
Entity Type | Organization |
Authorized Contact | KEVAN S. ZECHIN Owner 319-524-4300 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IA 32842) |
Enumeration Date | 2006-10-24 |
Last Update Date | 2020-08-22 |