Organization
SAC & FOX OF THE MISS IN IOWA
Active
Other names
Sac & Fox of The Miss In Iowa
Organization subpart
No
Provider details
NPI number
Authorized official
MIRZA GONZALES (DIRECTOR ADMINISTRATIVE SERVICES)
(641) 484-4094
Entity
Organization
Contact information
Practice address
1646 305TH STREET, STE A, TAMA, IA 52339-9634
(641) 484-4094
(641) 484-2432
Mailing address
1646 305TH STREET, TAMA, IA 52339-9634
(641) 484-4094
(641) 484-2432
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
05/15/2007
Last updated
07/15/2014
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