Healthcare Provider Details

I. General information

NPI: 1457274748
Provider Name (Legal Business Name): AQUATRIM MOLECULAR HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1247 N 25TH ST
FORT DODGE IA
50501-2110
US

IV. Provider business mailing address

1247 N 25TH ST
FORT DODGE IA
50501-2110
US

V. Phone/Fax

Practice location:
  • Phone: 515-341-1387
  • Fax:
Mailing address:
  • Phone: 515-341-1387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ANGELA MCGREGOR
Title or Position: DNP/OWNER
Credential: DNP
Phone: 515-341-1387