| NPI | 1316115876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLEEN KELLEHER Compliance Officer 515-226-7423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 1325) |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2010-03-25 |