| NPI | 1972831410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD DEWALL CEO 563-421-1586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: IA 036071509) |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2016-03-15 |