| |
542 Main Street Manilla IA 51454-0000 | |
(712) 654-2400 | |
Not Available |
Full Name | |
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Speciality | Physician Assistant - Medical |
Location | 542 Main Street, Manilla, Iowa |
Authorized Official Name and Position | Mark H. Rinehardt (ADMINISTRATOR/CEO) |
Authorized Official Contact | 7122631620 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2016 1st Ave S Denison IA 51442-2210 Ph: (712) 263-3388 | 542 Main Street Manilla IA 51454-0000 Ph: (712) 654-2400 |
NPI Number | 1730359878 |
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Provider Enumeration Date | 03/05/2008 |
Last Update Date | 03/05/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730359878 | NPI | - | NPPES |
0154542 | Medicaid | IA | |
51356 | Other | IA | WELLMARK |