| NPI | 1588156657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD ROGER LAURICH Medical Director, Owner 319-430-9340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2018-06-04 |