Organization
UNITED MEDICAL PARK ASC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE ANNE BLACKWELL (AUTHORIZED OFFICIAL)
(205) 824-6250
Entity
Organization
Contact information
Practice address
1731 W RIDGEWAY AVE, WATERLOO, IA 50701-4595
(319) 833-5858
Mailing address
1 CHASE CORPORATE DR STE 200, HOOVER, AL 35244-7060
(205) 824-6250
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
11/05/2019
Last updated
11/05/2019
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