Full Name | |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 112 East Main St., Ossian, Iowa |
Authorized Official Name and Position | Steven Robert Slessor (CAO) |
Authorized Official Contact | 5633873145 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
901 Montgomery St Decorah IA 52101-2325 Ph: (563) 382-2911 | 112 East Main St. Ossian IA 52101 Ph: (563) 532-9500 |
NPI Number | 1669893988 |
---|---|
Provider Enumeration Date | 01/06/2014 |
Last Update Date | 06/29/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669893988 | NPI | - | NPPES |
0214491 | Medicaid | IA | |
2214491 | Medicaid | IA | |
1214491 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 960127H (Iowa) | Primary |