| NPI | 1255886388 |
|---|---|
| Doing Business As | MERYCARE PRARIE CREEK |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY L CHARLES President CEO 319-398-6697 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2019-07-25 |