| NPI | 1457305047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID M TANCRETI President Physician 712-263-6116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 18503 Iowa 1971) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 19004 Iowa 1973) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2020-08-22 |