Organization · NPI-2
Iowa Medical Clinic, LLC
Family Medicine · Iowa, LA
NPI number1205419405
StatusActive
Last updated in NPPESJul 13, 2021
Details
- NPI
- 1205419405
- Entity type
- Organization (NPI-2)
- Legal business name
- Iowa Medical Clinic, LLC
- Organization subpart
- No
- Enumeration date
- May 4, 2021
- Certification date
- Jul 13, 2021
- Last updated
- Jul 13, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
621 E Miller AveIowa, LA 70647-4008
Phone 337-302-7955
Mailing address
621 E Miller AveIowa, LA 70647-4008
Phone 337-302-7955
Authorized official
Amy Guidry
Fnp-Bc
3373582601
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