Provider Demographics
NPI:1699070318
Name:INFINITY SKIN CARE & SPA LLC
Entity type:Organization
Organization Name:INFINITY SKIN CARE & SPA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:K
Authorized Official - Last Name:SCHULZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:319-337-5355
Mailing Address - Street 1:1100 5TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-2934
Mailing Address - Country:US
Mailing Address - Phone:319-337-5355
Mailing Address - Fax:319-337-5361
Practice Address - Street 1:1100 5TH ST STE 125
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2934
Practice Address - Country:US
Practice Address - Phone:319-337-5355
Practice Address - Fax:319-337-5361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-12
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty