Organization
BRAATEN HEALTH LLC
Active
Other names
Midwest Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNETTE D LANE (ACCOUNTS RECEIVABLE)
(563) 327-0133
Entity
Organization
Contact information
Practice address
5403 VICTORIA AVE, SUITE 20, DAVENPORT, IA 52807-3925
(563) 327-0132
(563) 359-5642
Mailing address
2035 BRIDGE AVE, DAVENPORT, IA 52803-2478
(563) 326-1400
(563) 326-0700
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0645085
—
IA
01
—
38860
WELLMARK BLUE CROSS BLUE SHIELD
—
Enumeration date
01/14/2009
Last updated
01/14/2009
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