| NPI | 1336523893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WYATT ALLEN SCHMIDT Physicain Assistant/Manager 712-256-7172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 002355) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A121973) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2015-10-02 |