Organization
RENEE D LASS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAM BELL (OFFICE MGR)
(563) 359-3736
Entity
Organization
Contact information
Practice address
4626 PROGRESS DR STE B, DAVENPORT, IA 52807-3485
(563) 359-3736
(563) 359-0153
Mailing address
4626 PROGRESS DR STE B, DAVENPORT, IA 52807-3485
(563) 359-3736
(563) 359-0153
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3589
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3444885
—
IA
Enumeration date
08/03/2006
Last updated
04/08/2008
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