Organization
IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
Active
Parent organization
IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
Other names
Grundy Center Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
Authorized official
ERICK J LAINE (COO)
(515) 471-9227
Entity
Organization
Contact information
Practice address
101 E J AVE, STE 120, GRUNDY CENTER, IA 50638-2006
(319) 824-6945
(319) 824-6947
Mailing address
8101 BIRCHWOOD COURT, SUITE R, JOHNSTON, IA 50131-2930
(515) 471-9243
(515) 471-9319
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0689539
—
IA
Enumeration date
06/20/2006
Last updated
08/15/2012
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