| NPI | 1205518933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN NYTES Manager 319-899-9139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2023-08-02 |
| Last Update Date | 2024-01-10 |