Individual
RALPH RIED BOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
709 W MAIN ST, MANCHESTER, IA 52057-1526
(563) 927-7985
(563) 927-7934
Mailing address
P.O. BOX 359, 709 W MAIN ST, MANCHESTER, IA 52057-0359
(563) 927-7985
(563) 927-7934
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22897
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0210831
—
IA
Enumeration date
07/08/2005
Last updated
10/28/2020
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