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General NPI Number Information
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NPI Number | 1942432406
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Entity Type | Organization
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Legal Business Name | BERTROCHE & ASSOCIATES
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Dates
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Enumeration Date | 08/18/2009
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Last Update Date | 10/13/2014
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Provider Practice Location Address
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Address Line | 5525 MEREDITH DRIVE SUITE B
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City | DES MOINES
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State | IA
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Zip | 50310-2334
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Country | US
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Telephone | 515-334-9484
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Fax | 515-334-9498
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Provider Business Mailing Address
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Address Line | 5525 MEREDITH DRIVE SUITE B
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City | DES MOINES
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State | IA
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Zip | 50310-2334
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Country | US
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Telephone | 515-334-9484
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Fax | 515-334-9498
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Authorized Official
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Title or Position | OWNER
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Name | J PATRICK BERTROCHE
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Credential | D.O.
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Telephone | 515-334-9484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 03220
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License Number State | IA
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