| Full Name | |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 800 Oak St, Sheldon, Iowa |
| Authorized Official Name and Position | Joel Mason Gustafson (ADMINISTRATOR) |
| Authorized Official Contact | 7123245356 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
800 Oak St P.o. Box 10 Sheldon IA 51201-1242 Ph: (712) 324-5356 | 800 Oak St Sheldon IA 51201-1242 Ph: (712) 324-5356 |
| NPI Number | 1982780144 |
|---|---|
| Provider Enumeration Date | 10/31/2006 |
| Last Update Date | 11/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982780144 | NPI | - | NPPES |
| 0254656 | Medicaid | IA | |
| 0638593 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Miedema Chiropractic Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 415 9th St, Sheldon, IA 51201 Phone: 712-324-9930 Fax: 712-324-4886 | |