# PREMISE HEALTH OF IOWA MEDICAL P C

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BAE Cedar Rapids
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003558057
- **Authorized official:** JONATHAN LEIZMAN (PRESIDENT)
- **Authorized official phone:** (615) 468-6270

## Contact information

- **Practice address:** 7825 6TH ST SW, CEDAR RAPIDS, IA 52404-7012
- **Practice address phone:** (615) 468-3188
- **Mailing address:** 5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/11/2022
- **Last updated:** 03/06/2023