| NPI | 1487881397 |
|---|---|
| Doing Business As | PACIFICA OUTPATIENT |
| Entity Type | Organization |
| Authorized Contact | ALLEN PHILIP WOLNERMAN Owner 515-285-2559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: IA 770692) |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech (Licence: IA 770692) |
| 261QX0100X Clinic/Center, Occupational Medicine (Licence: IA 770692) | |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2009-06-18 |