MEDICARE: CHILDREN'S THERAPY CENTER OF THE QUAD CITIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1003991217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDREN'S THERAPY CENTER OF THE QUAD CITIES

Provider Business Mailing Address
First Line	:	4450 48TH AVENUE CT
Second Line	:
City	:	ROCK ISLAND
State	:	IL
Zip	:	61201-9213
Country	:	US
Telephone Number	:	309-558-0145
Fax Number	:

Provider Business Practice Location Address
First Line	:	4450 48TH AVENUE CT
Second Line	:
City	:	ROCK ISLAND
State	:	IL
Zip	:	61201-9213
Country	:	US
Telephone Number	:	309-558-0145
Fax Number	:

Authorized Official
Title or Position	:	VP OF OPERATIONS
Name	:	TIMOTHY D SMITH
Credential	:
Telephone Number	:	309-558-0145

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	09/30/2024

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Directions to “CHILDREN'S THERAPY CENTER OF THE QUAD CITIES ” Practice Location

Language	Start Address	Practice Location

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