Healthcare Provider Details
I. General information
NPI: 1740094143
Provider Name (Legal Business Name): WEIGHT LOSS & WELLNESS CENTER OF IOWA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/05/2025
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4201 CORPORATE DR STE 100
WEST DES MOINES IA
50266-5906
US
IV. Provider business mailing address
12808 OAK BROOK CIR
URBANDALE IA
50323-8001
US
V. Phone/Fax
- Phone: 515-421-9355
- Fax: 515-329-6799
- Phone: 650-521-2615
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TERESA
LAMASTERS
Title or Position: CEO OWNER
Credential: MD
Phone: 650-521-2615