| NPI | 1861551665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY K COLEGROVE A RN P 712-322-2332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA 21611) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA 107489) |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2007-10-16 |