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Organization
PACIFICA HEALTH SERVICES LLC
Active
Organization
PACIFICA HEALTH SERVICES LLC
Active
Other names
Pacifica Outpatient
Organization subpart
No
Provider details
NPI number
Authorized official
ALLEN PHILIP WOLNERMAN RPH, FASCP (OWNER)
(515) 285-2559
Entity
Organization
Contact information
Practice address
4911 SW 19TH ST, DES MOINES, IA 50315-4487
(515) 285-2559
(515) 285-6487
Mailing address
4911 SW 19TH ST, DES MOINES, IA 50315-4487
(515) 285-2559
(515) 285-6487
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
770692
IA
261QP2000X
Physical Therapy Clinic/Center
Primary
770692
IA
261QX0100X
Occupational Medicine Clinic/Center
770692
IA
Other
Enumeration date
06/18/2009
Last updated
06/18/2009
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