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1111 6th Ave # W3 Des Moines IA 50314-2610 | |
| (515) 643-8350 | |
| (515) 643-5824 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1111 6th Ave # W3, Des Moines, Iowa |
| Authorized Official Name and Position | Bradley Whipple (COO) |
| Authorized Official Contact | 5153586956 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1475 Des Moines IA 50305-1475 Ph: (515) 643-8350 | 1111 6th Ave # W3 Des Moines IA 50314-2610 Ph: (515) 643-8350 |
| NPI Number | 1114578226 |
|---|---|
| Provider Enumeration Date | 09/20/2019 |
| Last Update Date | 10/11/2024 |
| Certification Date | 10/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114578226 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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