| NPI | 1386727204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN VINCENT DE REGNIER President 515-462-1162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 02175) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2009-01-30 |