Organization
MID IOWA SPEECH THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA LYNN BOLE MA. CCC SLP (PRESIDENT)
(515) 314-3800
Entity
Organization
Contact information
Practice address
6850 CERES CIR, JOHNSTON, IA 50131-1657
(515) 314-3800
(515) 270-9376
Mailing address
6850 CERES CIR, JOHNSTON, IA 50131-1657
(515) 314-3800
(515) 270-9376
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
471
IA
Other
Enumeration date
12/13/2013
Last updated
12/13/2013
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