| NPI | 1174793285 |
|---|---|
| Other Name | CCMH MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | NANCY J. CARLSON Chief Financial Officer 712-265-2505 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2011-11-28 |