| NPI | 1710330196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY MCMAHON VP 563-543-5363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: IA F087220) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2016-07-20 |