Organization
PHYSICIANS' CLINIC OF IOWA. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA S COOPER (CEO)
(319) 398-1772
Entity
Organization
Contact information
Practice address
709 W MAIN ST, MANCHESTER, IA 52057-1526
(563) 927-3232
Mailing address
600 7TH ST SE, CEDAR RAPIDS, IA 52401-2112
(319) 398-1500
(319) 398-1558
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184950005
DMERC NUMBER
IA
Enumeration date
06/20/2007
Last updated
08/22/2020
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