Healthcare Provider Details

I. General information

NPI: 1962606574
Provider Name (Legal Business Name): ROB MCMAHON LICENSED PLUMBER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ROB MCMAHON PLUMBING

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 CARROLL BLVD
DUNKERTON IA
50626-9752
US

IV. Provider business mailing address

323 CARROLL BLVD
DUNKERTON IA
50626-9752
US

V. Phone/Fax

Practice location:
  • Phone: 319-822-4429
  • Fax:
Mailing address:
  • Phone: 319-822-4429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: