# MIDWAY EQUESTRIAN LLC

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

## Provider details

- **NPI number:** 1801435441
- **Authorized official:** MR. TREVOR JOHN WHIPPLE (OWNER)
- **Authorized official phone:** (712) 350-1105

## Contact information

- **Practice address:** 4252 310TH ST, NORTHBORO, IA 51647-4012
- **Practice address phone:** (712) 534-2250
- **Mailing address:** 4252 310TH ST, NORTHBORO, IA 51647-4012
- **Mailing address phone:** (712) 350-1105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 12/30/2019
- **Last updated:** 12/30/2019