| NPI | 1467702142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE ANN HANCOCK Revenue Cycle Director 515-528-8312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35082095) |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health (Licence: OH 35082095) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2021-08-09 |