| NPI | 1417468281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE MARTIN HEFFERNAN Vice President 515-293-0026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IA 072381) |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2017-10-19 |