Organization
IOWA CITY PLASTIC SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDY M BRENNEMAN (OFFICE MANAGER)
(319) 337-3740
Entity
Organization
Contact information
Practice address
501 12TH AVE, SUITE 102, CORALVILLE, IA 52241-1774
(319) 337-3740
Mailing address
501 12TH AVE, SUITE 102, CORALVILLE, IA 52241-1774
(319) 337-3740
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
IA-19759
IA
Other
Enumeration date
03/21/2006
Last updated
08/22/2020
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