Healthcare Provider Details

I. General information

NPI: 1407765647
Provider Name (Legal Business Name): MIND & MATTER BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 E BURLINGTON ST
IOWA CITY IA
52240
US

IV. Provider business mailing address

209 E BURLINGTON ST
IOWA CITY IA
52240
US

V. Phone/Fax

Practice location:
  • Phone: 319-250-4101
  • Fax:
Mailing address:
  • Phone: 319-250-4101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHRISTOPHER RYAN HECK
Title or Position: PHYSICIAN ASSOCIATE
Credential: PHYSICIAN ASSOCIATE
Phone: 920-210-2478