Provider Demographics
NPI:1710285341
Name:AESTHETIC HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:AESTHETIC HEALTH AND WELLNESS
Other - Org Name:MEDWEST HEALTH & AESTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:P
Authorized Official - Last Name:VAN ZETTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-267-8808
Mailing Address - Street 1:2213 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-5305
Mailing Address - Country:US
Mailing Address - Phone:515-237-3974
Mailing Address - Fax:515-883-2692
Practice Address - Street 1:12129 UNIVERSITY AVE
Practice Address - Street 2:SUITE 1000
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8231
Practice Address - Country:US
Practice Address - Phone:515-267-8808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-07
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty