| NPI | 1790069243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID J KUSNER Owner 319-688-7440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: IA 29619) |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2011-10-03 |