| NPI | 1962081091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR VANDEN WYNBOOM Authorized Official 515-289-4549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2021-04-14 |