Organization
GREAT RIVER MEDICAL SERVICES
Active
Other names
Burlington Area Family Practice Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT S POETTING (ADMINISTRATOR)
(319) 754-4242
Entity
Organization
Contact information
Practice address
1201 W AGENCY RD, WEST BURLINGTON, IA 52655-1645
(319) 754-4242
(319) 754-4079
Mailing address
1201 W AGENCY RD, WEST BURLINGTON, IA 52655-1645
(319) 754-4242
(319) 754-4079
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0198473
—
IA
Enumeration date
12/01/2006
Last updated
10/09/2007
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