Organization
MISSISSIPPI MEDICAL PLAZA, LC
Active
Other names
Mississippi Valley Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN K LOHF (MANAGER)
(563) 344-6600
Entity
Organization
Contact information
Practice address
3400 DEXTER CT, #200, DAVENPORT, IA 52807-3461
(563) 344-6600
(563) 344-6699
Mailing address
3400 DEXTER CT, #200, DAVENPORT, IA 52807-3461
(563) 344-6600
(563) 344-6699
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0143073
—
IA
Enumeration date
04/25/2006
Last updated
09/19/2014
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