National Provider Identifier Database

FREDERICKSBURG FAMILY HEALTH CLINIC PLLC
Primary Care


Contact Information

FREDERICKSBURG FAMILY HEALTH CLINIC, PLLC
115 SCHULT RIDGE RD
FREDERICKSBURG, IA50630-9582
Phone: 563-237-5316
Fax:
Website:
Specialty Taxonomy Code
* Primary Care 261QP2300X

* Indicates primary specialty

NPI Profile & details for FREDERICKSBURG FAMILY HEALTH CLINIC, PLLC

NPI Number 1548596927
Legal business name
LBN
FREDERICKSBURG FAMILY HEALTH CLINIC, PLLC
Authorized official LUCAS BRINKMAN - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 10/20/2009
Last updated 10/20/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • IA License #: 3824
  • IA Medicaid: 0130401

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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