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General NPI Number Information
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NPI Number | 1003346461
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Entity Type | Organization
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Legal Business Name | I & K QUALITY HEALTH CARE
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Dates
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Enumeration Date | 06/18/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 229 JORDAN DR
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City | DOVER
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State | DE
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Zip | 19904-2004
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Country | US
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Telephone | 303-674-5259
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Fax |
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Provider Business Mailing Address
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Address Line | 229 JORDAN DR
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City | DOVER
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State | DE
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Zip | 19904-2004
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Country | US
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Telephone | 303-674-5259
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Fax |
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Authorized Official
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Title or Position | BS CM
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Name | ISAAC IVERSON QWEPUE
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Credential | NURSING
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Telephone | 215-431-5197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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