Provider Demographics
NPI:1952597536
Name:HIS HANDS FREE CLINIC
Entity Type:Organization
Organization Name:HIS HANDS FREE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROUWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-862-2636
Mailing Address - Street 1:400 12TH ST SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-4051
Mailing Address - Country:US
Mailing Address - Phone:319-862-2636
Mailing Address - Fax:319-862-1107
Practice Address - Street 1:1043 3RD AVE SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2409
Practice Address - Country:US
Practice Address - Phone:319-862-2636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable