Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Public Health, State or Local |
261QP0905X | |||
Ambulatory Family Planning Facility |
261QA0005X | |||
Case Manager/Care Coordinator |
171M00000X | |||
Public Health & General Preventive Medicine |
2083P0901X | 84 | Physician/Preventive Medicine |
| NPI # | 1710910781 |
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| LBN Legal business name | COUNTY OF POLK | ||||||||||||
| Authorized official | GREG HANSEN - (ADMINISTRATIVE OFFICER) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 07/10/2006 | ||||||||||||
| Last updated | 06/23/2015 - About 11 years ago | ||||||||||||
| Identifiers |
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COUNTY OF POLK
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