1841582731 NPI number — NORTH IOWA PHYSICAL THERAPY LLC

Table of content: (NPI 1841582731)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841582731 NPI number — NORTH IOWA PHYSICAL THERAPY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH IOWA PHYSICAL THERAPY LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1841582731
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 185
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BUFFALO CENTER
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50424-0185
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
641-562-2100
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
119 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUFFALO CENTER
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50424-7731
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-562-2100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/10/2011

Additional Information

Authorized Official

Authorized Official Last Name:
SPENCER-MCMULLEN
Authorized Official First Name:
AMY
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
712-301-6262

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  004322 , 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: 1841582731 . This is a "NPI" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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