| NPI | 1366706319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEROY L. YATES Owner 563-505-5372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IA 27540) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 036-076186) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2012-06-25 |