1457872111 NPI number — DR. TAMIE MARIE DREES PT, DPT, ATC

Table of content: DR. TAMIE MARIE DREES PT, DPT, ATC (NPI 1457872111)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457872111 NPI number — DR. TAMIE MARIE DREES PT, DPT, ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DREES
Provider First Name:
TAMIE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT, ATC
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:
1457872111
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5627 NW 86TH ST
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
JOHNSTON
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50131-1738
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-270-0303
Provider Business Mailing Address Fax Number:
515-270-0160

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6825 S 27TH ST STE 103
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68512-4872
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-420-0020
Provider Business Practice Location Address Fax Number:
402-420-0014
Provider Enumeration Date:
07/03/2017

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:  96755 , 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)





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