Healthcare Provider Details

I. General information

NPI: 1689209793
Provider Name (Legal Business Name): IOWA WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2020
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 JORDAN ST STE C
NORTH LIBERTY IA
52317-4759
US

IV. Provider business mailing address

1395 JORDAN ST STE C
NORTH LIBERTY IA
52317-4759
US

V. Phone/Fax

Practice location:
  • Phone: 319-289-0666
  • Fax:
Mailing address:
  • Phone: 319-289-0666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ABDULLAH ALWAHDANI
Title or Position: OWNER
Credential:
Phone: 319-289-0666