| NPI | 1770754954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE D LANE Accounts Receivable 563-327-0132 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2009-05-01 |