| NPI | 1730115213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK THAYER Clinic Adminstrator 641-792-2112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 213E00000X Podiatrist | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2013-06-13 |