| NPI | 1962785253 |
|---|---|
| Doing Business As | THE LEATHERMAN CLINIC |
| Entity Type | Organization |
| Authorized Contact | DANEN PAULY CEO 319-430-5645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IA 007350) |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2012-04-01 |