Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 05860 | IA |
NPI | 1003249756 |
---|---|
Provider Name | Dr. James Repass Power |
First Address | Spencer, IA 51301-4436 |
Second Address | Spencer, IA 51301-4436 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2013 |
Last Update Date | 16/08/2013 |