Full Name | |
---|---|
Speciality | Family Medicine |
Location | 401 1st Ave, Toledo, Iowa |
Authorized Official Name and Position | Terry Protextor (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 3193377642 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2941 Sierra Ct Sw Iowa City IA 52240-8503 Ph: () - | 401 1st Ave Toledo IA 52342-2129 Ph: (641) 484-2602 |
NPI Number | 1134177629 |
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Provider Enumeration Date | 05/05/2006 |
Last Update Date | 02/15/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134177629 | NPI | - | NPPES |
0689224 | Medicaid | IA | |
CI7793 | Other | IA | RR MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |