| NPI | 1275556532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE M CLARK Physician President 319-393-0110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IA 30509) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA 30559) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-08-22 |