| NPI | 1366190530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTELL MONICK HOWARD Owner/Operator 515-681-3143 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty |
| Enumeration Date | 2022-03-16 |
| Last Update Date | 2023-05-18 |