# GREAT RIVER MEDICAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Burlington Area Family Practice Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417025230
- **Authorized official:** MR. ROBERT S POETTING (ADMINISTRATOR)
- **Authorized official phone:** (319) 754-4242

## Contact information

- **Practice address:** 1201 W AGENCY RD, WEST BURLINGTON, IA 52655-1645
- **Practice address phone:** (319) 754-4242
- **Practice address fax:** (319) 754-4079
- **Mailing address:** 1201 W AGENCY RD, WEST BURLINGTON, IA 52655-1645
- **Mailing address phone:** (319) 754-4242
- **Mailing address fax:** (319) 754-4079

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | IA | Yes |

## Other

- **Enumeration date:** 12/01/2006
- **Last updated:** 10/09/2007