Organization
AEGIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNA YOUNG (PTA)
(319) 288-0875
Entity
Organization
Contact information
Practice address
819 COUNTRY LANE RD, KEOSAUQUA, IA 52565-1001
(310) 293-3671
Mailing address
819 COUNTRY LANE RD, KEOSAUQUA, IA 52565-1001
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
00969
IA
Other
Enumeration date
10/03/2013
Last updated
10/03/2013
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