Organization
IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE KENNEDY (CREDENTIALING SPECIALIST)
(515) 471-9243
Entity
Organization
Contact information
Practice address
827 S JACKSON ST, OSCEOLA, IA 50213-1666
(641) 342-2128
Mailing address
8101 BIRCHWOOD CT, SUITE N, JOHNSTON, IA 50131-2930
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
002433
IA
Other
Enumeration date
10/15/2013
Last updated
12/02/2013
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