Organization
DEER CREEK HEALTH CENTER, LLC
Active
Other names
Deer Creek Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY PROTEXTOR (EXECUTIVE DIRECTOR)
(319) 337-7642
Entity
Organization
Contact information
Practice address
401 1ST AVE, TOLEDO, IA 52342-2129
(641) 484-2602
Mailing address
2941 SIERRA CT SW, IOWA CITY, IA 52240-8503
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0689224
—
IA
01
—
CI7793
RR MEDICARE
IA
Enumeration date
05/05/2006
Last updated
02/15/2008
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