Healthcare Provider Details

I. General information

NPI: 1861549842
Provider Name (Legal Business Name): COUNTY OF JONES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 JOHN DR
MONTICELLO IA
52310-9410
US

IV. Provider business mailing address

814 JOHN DR
MONTICELLO IA
52310-9410
US

V. Phone/Fax

Practice location:
  • Phone: 319-465-6564
  • Fax: 319-462-5815
Mailing address:
  • Phone: 319-465-6564
  • Fax: 319-462-5815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347B00000X
TaxonomyBus
License NumberIA04631
License Number StateIA

VIII. Authorized Official

Name: MRS. JAMIE L GINTER
Title or Position: MANAGER
Credential:
Phone: 319-465-6564