Healthcare Provider Details

I. General information

NPI: 1194927806
Provider Name (Legal Business Name): JOHNSON COUNTY SEATS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 JAMES ST
CORALVILLE IA
52241-1800
US

IV. Provider business mailing address

2000 JAMES ST
CORALVILLE IA
52241-1800
US

V. Phone/Fax

Practice location:
  • Phone: 319-339-6128
  • Fax: 319-339-6185
Mailing address:
  • Phone: 319-339-6128
  • Fax: 319-339-6185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State

VIII. Authorized Official

Name: BRIAN R HULKE
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 319-339-6128