| NPI | 1477717197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANUMANTHA R. KOLUSU President 563-243-2022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IA 31016) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2019-08-15 |