| Fredericksburg Family Health Clinic, Pllc | |
|
115 Schult Ridge Rd Fredericksburg IA 50630-9582 | |
| (563) 237-5316 | |
| Not Available |
| Full Name | Fredericksburg Family Health Clinic, Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 115 Schult Ridge Rd, Fredericksburg, Iowa |
| Authorized Official Name and Position | Lucas Brinkman (OWNER) |
| Authorized Official Contact | 5632375316 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fredericksburg Family Health Clinic, Pllc 115 Schult Ridge Rd Fredericksburg IA 50630-9582 Ph: (563) 237-5316 | Fredericksburg Family Health Clinic, Pllc 115 Schult Ridge Rd Fredericksburg IA 50630-9582 Ph: (563) 237-5316 |
| NPI Number | 1548596927 |
|---|---|
| Provider Enumeration Date | 10/20/2009 |
| Last Update Date | 10/20/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548596927 | NPI | - | NPPES |
| 0130401 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 3824 (Iowa) | Primary |
Fredericksburg Family Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 Schult Ridge Rd, Fredericksburg, IA 50630 Phone: 563-237-5316 Fax: 563-237-6337 |