Healthcare Provider Details

I. General information

NPI: 1144274739
Provider Name (Legal Business Name): WESTERN IOWA SLEEP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 W 5TH ST
CARROLL IA
51401-2719
US

IV. Provider business mailing address

106 W 5TH ST
CARROLL IA
51401-2719
US

V. Phone/Fax

Practice location:
  • Phone: 712-775-2381
  • Fax: 712-775-2382
Mailing address:
  • Phone: 712-775-2381
  • Fax: 712-775-2382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License NumberN/A
License Number StateIA

VIII. Authorized Official

Name: MRS. SHARON K BEST
Title or Position: VICE PRESIDENT/OWNER
Credential:
Phone: 712-775-2381