| Renee D Lass | |
|
4626 Progress Dr Ste B Davenport IA 52807-3485 | |
| (563) 359-3736 | |
| (563) 359-0153 |
| Full Name | Renee D Lass |
|---|---|
| Speciality | Family Medicine |
| Location | 4626 Progress Dr Ste B, Davenport, Iowa |
| Authorized Official Name and Position | Pam Bell (OFFICE MGR) |
| Authorized Official Contact | 5633593736 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renee D Lass 4626 Progress Dr Ste B Davenport IA 52807-3485 Ph: (563) 359-3736 | Renee D Lass 4626 Progress Dr Ste B Davenport IA 52807-3485 Ph: (563) 359-3736 |
| NPI Number | 1043228604 |
|---|---|
| Provider Enumeration Date | 08/03/2006 |
| Last Update Date | 04/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043228604 | NPI | - | NPPES |
| 3444885 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3589 (Iowa) | Primary |
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