| NPI | 1003326299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARITY VANCLEVE Owner/President 563-587-8317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: IA 03815) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2018-01-18 |