NPI | 1962453274 |
---|---|
Entity Type | Organization |
Authorized Contact | CHAD THOMAS CARLSON CEO, Stadia Sports Medicine 515-221-1102 |
Organization Subpart ? | No |
Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: IA 36501) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2006-05-12 |
Last Update Date | 2017-08-16 |