| NPI | 1760896211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCO ROUMAN President 319-594-4377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: IA 08905) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2014-06-12 |