Organization
IOWA PLASTIC SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN ADAM VAN RAALTE M.D. (OWNER)
(563) 322-8877
Entity
Organization
Contact information
Practice address
4334 E 53RD ST, DAVENPORT, IA 52807-3039
(563) 322-8877
Mailing address
4334 E 53RD ST, DAVENPORT, IA 52807-3039
(563) 322-8877
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
29526
IA
Other
Enumeration date
06/27/2008
Last updated
06/27/2008
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