Organization Name: | GUNDERSEN CLINIC, LTD. |
NPI Number: | 1053366518 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KARI B ADANK (CCO) |
Mailing Address: | 110 King Street Fayette |
State: | IA US |
Postal Code: | 52142 |
Phone Number: | 6087827300 |
Fax Number: | |
NPI Enumeration Date: | 05/23/2006 |
NPI Last Update Date: | 03/07/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |