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804 Kenyon Rd Ste D Fort Dodge IA 50501-5744 | |
| (515) 574-6855 | |
| (515) 573-7274 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 804 Kenyon Rd, Fort Dodge, Iowa |
| Authorized Official Name and Position | Michael J Dewerff (CFO) |
| Authorized Official Contact | 5155746603 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
802 Kenyon Rd Fort Dodge IA 50501-5740 Ph: (515) 574-6890 | 804 Kenyon Rd Ste D Fort Dodge IA 50501-5744 Ph: (515) 574-6855 |
| NPI Number | 1033527114 |
|---|---|
| Provider Enumeration Date | 08/01/2014 |
| Last Update Date | 02/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033527114 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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