| NPI | 1205098449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE LANSINK Owner 319-277-5808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: IA 1291) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2008-06-30 |