Provider Demographics
NPI:1689778201
Name:KORVER EAR NOSE & THROAT, LLC
Entity Type:Organization
Organization Name:KORVER EAR NOSE & THROAT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCI
Authorized Official - Middle Name:JENE
Authorized Official - Last Name:BAKKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-707-9585
Mailing Address - Street 1:907 LINCOLN CIR SE
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51041-1859
Mailing Address - Country:US
Mailing Address - Phone:712-707-9585
Mailing Address - Fax:
Practice Address - Street 1:907 LINCOLN CIR SE
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:IA
Practice Address - Zip Code:51041-1859
Practice Address - Country:US
Practice Address - Phone:712-707-9585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center