| NPI | 1992912372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS LEE KRUTSINGER Chief Executive Officer 641-342-1470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IA 00581) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 00705) |
| 225100000X Physical Therapist (Licence: IA 03688) | |
| 225200000X Physical Therapy Assistant (Licence: IA 000103) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2015-08-20 |