| NPI | 1922279439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELIA RENEE WHETRO Med Director 515-225-2578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 03475) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001132) |
| 111N00000X Chiropractor (Licence: IA 007026) | |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2008-12-02 |