Organization
CITY OF LA PORTE CITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE L DAVISON (AUTHORIZED OFFICIAL)
(319) 342-2232
Entity
Organization
Contact information
Practice address
202 MAIN ST, LA PORTE CITY, IA 50651-1234
(319) 342-2232
(319) 342-3770
Mailing address
202 MAIN ST, LA PORTE CITY, IA 50651-1234
(319) 342-2232
(319) 342-3770
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
2070600
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00390
PRIVATE INSURANCE CO'S
IA
05
—
0039008
—
IA
05
—
0458661
—
IA
01
—
I12613
PTAN
IA
Enumeration date
05/27/2005
Last updated
03/13/2017
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