| Midway Equestrian Llc | |
|
4252 310th St Northboro IA 51647-4012 | |
| (712) 534-2250 | |
| Not Available |
| Full Name | Midway Equestrian Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4252 310th St, Northboro, Iowa |
| Authorized Official Name and Position | Trevor John Whipple (OWNER) |
| Authorized Official Contact | 7123501105 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midway Equestrian Llc 4252 310th St Northboro IA 51647-4012 Ph: (712) 350-1105 | Midway Equestrian Llc 4252 310th St Northboro IA 51647-4012 Ph: (712) 534-2250 |
| NPI Number | 1801435441 |
|---|---|
| Provider Enumeration Date | 12/30/2019 |
| Last Update Date | 12/30/2019 |
| Certification Date | 12/30/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801435441 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |