| NPI | 1659904803 |
|---|---|
| Doing Business As | IOWA KETAMINE CLINIC |
| Entity Type | Organization |
| Authorized Contact | SHAWN C TULP Chief Operations Officer 520-390-5411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2020-02-17 |