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Organization
FAMILY PRACTICE CENTER
Active
Organization
FAMILY PRACTICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP PETERSON (SR. VICE PRESIDENT/CFO FINANCE)
(319) 398-6793
Entity
Organization
Contact information
Practice address
610 8TH ST SE, CEDAR RAPIDS, IA 52401-2143
(319) 398-6170
(319) 398-6466
Mailing address
610 8TH ST SE, CEDAR RAPIDS, IA 52401-2143
(319) 398-6170
(319) 398-6466
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/13/2006
Last updated
08/12/2008
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