Provider Demographics
NPI:1063673549
Name:LOUISA-MUSCATINE
Entity Type:Organization
Organization Name:LOUISA-MUSCATINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KARRON
Authorized Official - Middle Name:
Authorized Official - Last Name:STINEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-726-3541
Mailing Address - Street 1:14478 170TH ST
Mailing Address - Street 2:
Mailing Address - City:LETTS
Mailing Address - State:IA
Mailing Address - Zip Code:52754-9475
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14478 170TH ST
Practice Address - Street 2:
Practice Address - City:LETTS
Practice Address - State:IA
Practice Address - Zip Code:52754-9475
Practice Address - Country:US
Practice Address - Phone:319-726-3541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)