| NPI | 1912316969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEMORY SUE PORTER Owner 515-975-9525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: IA 03575) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2024-01-08 |