| NPI | 1912363243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE S GILLIS President 319-551-1940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: CA G30367) |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2015-12-31 |