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General NPI Number Information
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NPI Number | 1114474590
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Entity Type | Organization
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Legal Business Name | BRIDGES TO BETTERMENT
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Dates
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Enumeration Date | 09/02/2016
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Last Update Date | 09/02/2016
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Provider Practice Location Address
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Address Line | 1211 VINE ST
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City | WEST DES MOINES
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State | IA
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Zip | 50265-4472
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Country | US
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Telephone | 888-778-5833
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Fax |
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Provider Business Mailing Address
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Address Line | 1211 VINE ST
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City | WEST DES MOINES
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State | IA
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Zip | 50265-4472
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN
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Name | LAWRENCE EDWARD JAMES SR.
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Credential | JD
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Telephone | 515-491-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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