| NPI | 1386909331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY CARTER MCKERNAN Physician/Manager/Member 641-203-3548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 02827) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2012-07-06 |