| NPI | 1891925251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY L MATHIS Owner 563-676-1765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: IA 007163) |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2009-07-20 |