| NPI | 1770743130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY R STURGES Director CEO 712-274-8071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IA 1218) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2008-06-10 |