Provider Demographics
NPI:1780736256
Name:NORTH LIBERTY FAMILY HEALTH CENTRE, P.C.
Entity type:Organization
Organization Name:NORTH LIBERTY FAMILY HEALTH CENTRE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAESTNER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:319-626-6006
Mailing Address - Street 1:PO BOX 260
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-0260
Mailing Address - Country:US
Mailing Address - Phone:319-626-6006
Mailing Address - Fax:319-626-3400
Practice Address - Street 1:585 W CHERRY ST
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-9797
Practice Address - Country:US
Practice Address - Phone:319-626-6006
Practice Address - Fax:319-626-3400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty