| NPI | 1699487678 |
|---|---|
| Other Name | MANAGER |
| Entity Type | Organization |
| Authorized Contact | WENDY KELLY Office Administrator 563-650-2158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease |
| 251K00000X Public Health or Welfare | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2022-12-21 |
| Last Update Date | 2023-03-10 |