Organization
DIAMOND MEDICAL SPA AND VEIN, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEROY L. YATES MD (OWNER)
(563) 505-5372
Entity
Organization
Contact information
Practice address
3170 E 53RD ST, DAVENPORT, IA 52807-3864
(563) 505-5372
Mailing address
3170 E 53RD ST, DAVENPORT, IA 52807-3864
(563) 505-5372
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
036-076186
IL
207V00000X
Obstetrics & Gynecology Physician
Primary
27540
IA
Other
Enumeration date
06/25/2012
Last updated
06/25/2012
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