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General NPI Number Information
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NPI Number | 1306566328
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Entity Type | Organization
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Legal Business Name | ALTRUITY HEALTHCARE AND WELLNESS
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Dates
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Enumeration Date | 08/30/2022
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Last Update Date | 01/28/2024
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Provider Practice Location Address
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Address Line | 1212 W MARION ST
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City | MANCHESTER
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State | IA
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Zip | 52057-2314
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Country | US
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Telephone | 563-822-0081
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Fax |
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Provider Business Mailing Address
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Address Line | 1212 W MARION ST
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City | MANCHESTER
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State | IA
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Zip | 52057-2314
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Country | US
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Telephone | 563-822-0081
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Fax | 563-822-1052
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Authorized Official
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Title or Position | ARNP, FNP-BC, CEO
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Name | MELINDA MARIE JACKSON
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Credential |
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Telephone | 563-822-0081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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