Healthcare Provider Details

I. General information

NPI: 1982856779
Provider Name (Legal Business Name): MIDWEST HEALTH CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2008
Last Update Date: 10/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 E 7TH ST
ATLANTIC IA
50022-1812
US

IV. Provider business mailing address

1101 E 7TH ST
ATLANTIC IA
50022-1812
US

V. Phone/Fax

Practice location:
  • Phone: 712-243-5790
  • Fax: 712-243-3975
Mailing address:
  • Phone: 712-243-5790
  • Fax: 712-243-3975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. ALISHA NICOLE HASS
Title or Position: BILLING MANAGER
Credential:
Phone: 712-243-5790