Organization
FREDERICKSBURG FAMILY HEALTH CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUCAS BRINKMAN D.O. (OWNER)
(563) 237-5316
Entity
Organization
Contact information
Practice address
115 SCHULT RIDGE RD, FREDERICKSBURG, IA 50630-9582
(563) 237-5316
Mailing address
115 SCHULT RIDGE RD, FREDERICKSBURG, IA 50630-9582
(563) 237-5316
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
3824
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0130401
—
IA
Enumeration date
10/20/2009
Last updated
10/20/2009
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