Organization
GRACE BREAST IMAGING & MEDICAL SPA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA LAMPHIEAR (MEMBER)
(515) 505-3224
Entity
Organization
Contact information
Practice address
1250 NW 128TH ST STE 130, CLIVE, IA 50325-7433
(515) 505-3224
Mailing address
1250 NW 128TH ST STE 130, CLIVE, IA 50325-7433
(515) 505-3224
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
261QR0206X
Mammography Clinic/Center
—
—
Other
Enumeration date
06/04/2024
Last updated
06/05/2024
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