| NPI | 1750633087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY MARIE FREDERICKSEN Pediatric Nurse Practitioner 515-771-6691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IA C-119097) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2012-10-10 |