| NPI | 1457863318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA L FORD Projects & Member Services Coord 319-339-3993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2020-01-27 |