| NPI | 1508400508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY LUJAN Admin Director 563-370-2784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 111N00000X Chiropractor |
| 225100000X Physical Therapist | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2020-02-20 |