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2701 23rd Ave Council Bluffs IA 51501-6958 | |
| (712) 396-3722 | |
| (712) 396-3997 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2701 23rd Ave, Council Bluffs, Iowa |
| Authorized Official Name and Position | Steven Ashley Hinitt (PRESIDENT) |
| Authorized Official Contact | 2105635077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5500 Maryland Way Brentwood TN 37027-7048 Ph: () - | 2701 23rd Ave Council Bluffs IA 51501-6958 Ph: (712) 396-3722 |
| NPI Number | 1285302984 |
|---|---|
| Provider Enumeration Date | 08/30/2021 |
| Last Update Date | 10/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285302984 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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