| NPI | 1194256453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE ALLARD Medical Office Administrator 515-512-9225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2018-12-06 |