| NPI | 1346229192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID PAUL ROHLF President 563-359-1641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2023-11-13 |