Organization
SPECTRUM INDUSTRIES
Active
Other names
The Spectrum Network
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER MICHAEL MICULINICH (EXECUTIVE DIRECTOR)
(563) 382-8401
Entity
Organization
Contact information
Practice address
607 WASHINGTON STREET, SUITE 1, DECORAH, IA 52101-2240
(563) 382-8401
(563) 382-8403
Mailing address
607 WASHINGTON STREET, SUITE 1, DECORAH, IA 52101-2240
(563) 382-8401
(563) 382-8403
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251F00000X
Home Infusion Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0166983
—
IA
05
—
02-35754
—
IA
05
—
12-35754
—
IA
05
—
2235754
—
IA
Enumeration date
10/04/2006
Last updated
12/20/2024
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