NPI | 1598216244 |
---|---|
Entity Type | Organization |
Authorized Contact | JOE LOCK CEO 319-730-7300 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 208000000X Pediatrics |
261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
Enumeration Date | 2016-10-18 |
Last Update Date | 2021-06-08 |