Organization
ROOTED PEDIATRIC HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE ANN MACTAGGART CPNP-PC (PEDIATRIC NURSE PRACTITIONER)
(319) 480-2540
Entity
Organization
Contact information
Practice address
105 E BUTLER ST, MANCHESTER, IA 52057-1606
(319) 480-2540
Mailing address
715 ANDERSON ST, MANCHESTER, IA 52057-1401
(319) 480-2540
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/14/2024
Last updated
04/22/2024
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