| |
813 Church St., Shenandoah, IA 51601 | |
(712) 246-5866 | |
(712) 623-2703 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist |
Location | 813 Church St., Shenandoah, Iowa |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1912119124 | NPI | - | NPPES |
0429761 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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502 E Reed St., Red Oak, IA 51566 Ph: (712) 623-5178 | 813 Church St., Shenandoah, IA 51601 Ph: (712) 246-5866 |