Organization
HAIR CARE ON FIFTH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOREEN F GILLESPIE (PRESIDENT)
(515) 382-6633
Entity
Organization
Contact information
Practice address
1103 5TH ST, NEVADA, IA 50201-1816
(515) 382-6633
(515) 382-8084
Mailing address
1103 5TH ST, NEVADA, IA 50201-1816
(515) 382-6633
(515) 382-8084
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0234914
—
IA
01
—
055629
HEALTH ALLIANCE
—
01
—
52744
BLUE CROSS BLUE SHIELD
—
01
—
F247674
MIDLAND CHOICE
—
Enumeration date
01/30/2006
Last updated
03/09/2011
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