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Midway Equestrian LLC

Counselor, Mental Health in Northboro, IA. Organization (NPI-2).

NPI number1801435441
StatusActive
Last updated in NPPESDec 30, 2019

Details

NPI
1801435441
Entity type
Organization (NPI-2)
Legal business name
Midway Equestrian LLC
Organization subpart
No
Enumeration date
Dec 30, 2019
Certification date
Dec 30, 2019
Last updated
Dec 30, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental Health––Yes

Practice location

4252 310th St
Northboro, IA 51647-4012

Phone 712-534-2250

Mailing address

4252 310th St
Northboro, IA 51647-4012

Phone 712-350-1105

Authorized official

Trevor John Whipple
Owner
7123501105

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