Healthcare Provider Details

I. General information

NPI: 1225574825
Provider Name (Legal Business Name): V AND D LEASING, LC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2017
Last Update Date: 01/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 NE 5T ST #16
ANKENY IA
50023
US

IV. Provider business mailing address

PO BOX 998
DES MOINES IA
50304-0998
US

V. Phone/Fax

Practice location:
  • Phone: 515-991-1981
  • Fax:
Mailing address:
  • Phone: 515-289-9803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number StateIA

VIII. Authorized Official

Name: LEE E NIKOLAS
Title or Position: PRESIDENT
Credential:
Phone: 515-289-9800