Mine
NPI #1760916779 in Des Moines, Iowa
Provider Information
- NPI Number
- 1760916779
- Entity Type
- Organization
- Organization Name
- Mine
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- YTUKJTYKJT
- Primary Specialty
- Health Maintenance Organization
- Enumeration Date
- Apr 17, 2017
- Last Updated
- Apr 17, 2017
Practice Location
- Address
- 2 SW 9TH ST
- Address 2
- 316
- City
- Des Moines
- State
- Iowa
- ZIP Code
- 50309-4310
- Phone
- (515) 729-9350
Authorized Official
- Name
- MR. ROBERT DEAN FORKNER III, UI
- Title
- MYSELF
- Phone
- (515) 729-9350
Specialties & Taxonomy Codes
| Specialty |
|---|
| Health Maintenance Organization |
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