| NPI | 1720146319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD WOLBERS CEO 563-690-2862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA 08349) |
| 207Q00000X Family Medicine (Licence: IA A100692) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2025-07-09 |