# PREVENTATIVE HEALTH CLINIC INC

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

## Provider details

- **NPI number:** 1922279439
- **Authorized official:** ANGELIA RENEE WHETRO DO (MED DIRECTOR)
- **Authorized official phone:** (515) 225-2578

## Contact information

- **Practice address:** 2480 BERKSHIRE PKWY, CLIVE, IA 50325-4678
- **Practice address phone:** (515) 225-2578
- **Practice address fax:** (515) 225-2598
- **Mailing address:** 2213 GRAND AVE, DES MOINES, IA 50312-5305
- **Mailing address phone:** (515) 237-3974
- **Mailing address fax:** (515) 883-2692

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 007026 | IA | — |
| 207Q00000X | Family Medicine Physician | 03475 | IA | Yes |
| 363A00000X | Physician Assistant | 001132 | IA | — |

## Other

- **Enumeration date:** 03/13/2008
- **Last updated:** 12/02/2008