Organization
GARY VOLENTINE MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TAMMY K COLEGROVE ARNP (ARNP)
(712) 322-2332
Entity
Organization
Contact information
Practice address
801 HARMONY ST, SUITE 404, COUNCIL BLUFFS, IA 51503-3106
(712) 322-2332
(712) 322-5122
Mailing address
801 HARMONY ST, SUITE 404, COUNCIL BLUFFS, IA 51503-3106
(712) 322-2332
(712) 322-5122
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
21611
IA
363LF0000X
Family Nurse Practitioner
107489
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3941278
—
IA
Enumeration date
12/07/2006
Last updated
10/16/2007
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