| NPI | 1376814335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE GRAY Owner 319-329-8132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IA H-117587) |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2018-02-28 |