# HEALTHSOURCE OF IOWA CITY, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336408640
- **Authorized official:** DR. JEFFREY WISDO DC (PRESIDENT)
- **Authorized official phone:** (563) 508-9036

## Contact information

- **Practice address:** 960 S 1ST AVE, IOWA CITY, IA 52245-5210
- **Practice address phone:** (563) 508-9036
- **Mailing address:** 960 S 1ST AVE, IOWA CITY, IA 52245-5210

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/07/2012
- **Last updated:** 05/07/2012