| NPI | 1568531556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C KENT BOESE Owner Physician 712-388-0150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 02623) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2020-08-22 |