NPI
Mosaic
This page is a copy of the public NPPES file.
Facts
- Status
- Active
- Type
- Organization
- Enumeration date
- 2007-01-18
- Last updated
- 2020-08-22
Specialties
Licenses
- License IA
- 780204
Location
- Practice location
- 217 E 7th St
- City
- Logan IA
- Postal code
- 51546-1348
- Phone
- (712) 644-2378
Organization contact
- Name
- DEAN WILSON
- Title
- VP Accounting
- Phone
- 4028963884
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. OIG's online search is the official check.
Nearby
Other NPIs in Logan, IA. 34 records in the public file.
Removal request
Public data from NPPES and CMS. Not a credentialing determination.
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