| NPI | 1700819711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD GERALD MARTINEK Owner/Provider 641-231-1263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 02267) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-08-22 |