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Organization

CORNERSTONE PEDIATRICS AND FAMILY ALLERGY, PLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TARA J FEDERLY (OWNER/PHYSICIAN)
(952) 546-6866
Entity
Organization

Contact information

Practice address
6800 LAKE DRIVE, #260, WEST DES MONIES, IA 50266
(515) 822-3192
Mailing address
6800 LAKE DRIVE, #260, WEST DES MONIES, IA 50266
(515) 822-3192

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
208000000X
Pediatrics Physician

Other

Enumeration date
06/17/2019
Last updated
07/30/2020
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