| |
302 Sw Walnut St Ankeny IA 50023-3042 | |
(515) 964-8993 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 302 Sw Walnut St, Ankeny, Iowa |
Authorized Official Name and Position | Rebecca Lenz (DIRECTOR) |
Authorized Official Contact | 5156438727 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1475 Des Moines IA 50305-1475 Ph: (515) 543-4374 | 302 Sw Walnut St Ankeny IA 50023-3042 Ph: (515) 964-8993 |
NPI Number | 1538342662 |
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Provider Enumeration Date | 12/12/2007 |
Last Update Date | 02/08/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538342662 | NPI | - | NPPES |
CD3776 | Other | IA | RAILROAD MEDICARE |
0400636 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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