| NPI | 1285809095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY ELLERBROEK Billing Manager 712-224-8678 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: IA 350225) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2009-07-30 |