Organization
FAMILY CARE PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY J COPPOLA DO (OWNER)
(515) 967-4252
Entity
Organization
Contact information
Practice address
753 8TH ST SW, ALTOONA, IA 50009-2304
(515) 967-4252
Mailing address
753 8TH ST SW, ALTOONA, IA 50009-2304
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
02453
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0066845
—
IA
Enumeration date
12/04/2007
Last updated
12/04/2007
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