Healthcare Provider Details

I. General information

NPI: 1801845110
Provider Name (Legal Business Name): PALMER LUTHERAN HEALTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 07/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 JEFFERSON STREET
WEST UNION IA
52175
US

IV. Provider business mailing address

112 JEFFERSON STREET
WEST UNION IA
52175
US

V. Phone/Fax

Practice location:
  • Phone: 563-422-3811
  • Fax: 563-422-9754
Mailing address:
  • Phone: 563-422-3811
  • Fax: 563-422-9754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TANYA A. TYSLAND
Title or Position: CEO
Credential:
Phone: 563-422-3811