Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 101 N Main St, Fonda, Iowa |
Authorized Official Name and Position | Michael J Dewerff (CEO) |
Authorized Official Contact | 5155733101 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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802 Kenyon Rd Fort Dodge IA 50501-5740 Ph: (515) 574-6565 | 101 N Main St Fonda IA 50540-7729 Ph: (712) 228-4426 |
NPI Number | 1104344845 |
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Provider Enumeration Date | 09/01/2017 |
Last Update Date | 10/25/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104344845 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |