1003803438 NPI number — MS. BETH ANN SCHWEIZER P.T.

Table of content: MS. BETH ANN SCHWEIZER P.T. (NPI 1003803438)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003803438 NPI number — MS. BETH ANN SCHWEIZER P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWEIZER
Provider First Name:
BETH
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003803438
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
850 43RD AVE STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOLINE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
61265-8401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
309-743-2070
Provider Business Mailing Address Fax Number:
309-743-2073

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5700 UNIVERSITY AVE
Provider Second Line Business Practice Location Address:
STE 222
Provider Business Practice Location Address City Name:
WEST DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50266-8224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-221-1621
Provider Business Practice Location Address Fax Number:
515-221-1626
Provider Enumeration Date:
09/30/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  01901 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01901 . This is a "IOWA PT LICENSE NO." identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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