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1201 W Agency Rd West Burlington IA 52655-1645 | |
| (319) 754-4242 | |
| (319) 754-4079 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 1201 W Agency Rd, West Burlington, Iowa |
| Authorized Official Name and Position | Robert S Poetting (ADMINISTRATOR) |
| Authorized Official Contact | 3197544242 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1201 W Agency Rd West Burlington IA 52655-1645 Ph: (319) 754-4242 | 1201 W Agency Rd West Burlington IA 52655-1645 Ph: (319) 754-4242 |
| NPI Number | 1417025230 |
|---|---|
| Provider Enumeration Date | 12/01/2006 |
| Last Update Date | 10/09/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417025230 | NPI | - | NPPES |
| 0198473 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Iowa) | Primary |
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