| NPI | 1285996215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M AGUIRRE Owner 515-606-4551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IA 31043) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2012-06-18 |