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General NPI Number Information
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NPI Number | 1124365747
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Entity Type | Organization
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Legal Business Name | MERCY CLINICS, INC
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Dates
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Enumeration Date | 01/16/2013
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Last Update Date | 01/16/2013
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Provider Practice Location Address
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Address Line | 1111 6TH AVE. EAST TOWER SUITE: B1
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City | DES MOINES
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State | IA
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Zip | 50314-2610
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Country | US
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Telephone | 515-358-2225
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Fax | 515-358-0181
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Provider Business Mailing Address
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Address Line | PO BOX 1475
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City | DES MOINES
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State | IA
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Zip | 50305-1475
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Country | US
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Telephone | 515-358-2225
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Fax | 515-358-0181
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DAVID H VELLINGA
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Credential |
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Telephone | 515-247-4287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | IA
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