Organization
IKC, LLC
Active
Other names
Iowa Ketamine Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE OTTEN (REVENUE CYCLE DIRECTOR)
(515) 710-8720
Entity
Organization
Contact information
Practice address
1701 48TH ST STE 260, WEST DES MOINES, IA 50266-6726
(515) 401-4774
(515) 254-3092
Mailing address
1701 48TH ST STE 260, WEST DES MOINES, IA 50266-6726
(515) 401-4774
(515) 254-3092
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
02/17/2020
Last updated
10/05/2025
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