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General NPI Number Information
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NPI Number | 1710936604
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Entity Type | Organization
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Legal Business Name | MASON CITY CLINIC
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 250 S CRESCENT DR
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City | MASON CITY
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State | IA
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Zip | 50401-2926
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Country | US
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Telephone | 641-422-6680
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Fax |
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Provider Business Mailing Address
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Address Line | 250 S CRESCENT DR
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City | MASON CITY
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State | IA
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Zip | 50401-2926
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Country | US
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Telephone | 641-422-6680
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. DANA R YOUNG
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Credential |
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Telephone | 641-422-6509
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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