| NPI | 1730288556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY S WALCZYK Owner/President 563-441-5860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 26742) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |