MEDICARE: PELLA HEALTH & FITNESS PC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist		IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073511630
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PELLA HEALTH & FITNESS PC

Provider Business Mailing Address
First Line	:	2500 FIFIELD RD
Second Line	:
City	:	PELLA
State	:	IA
Zip	:	50219-7941
Country	:	US
Telephone Number	:	641-621-1401
Fax Number	:	614-628-7308

Provider Business Practice Location Address
First Line	:	2500 FIFIELD RD
Second Line	:
City	:	PELLA
State	:	IA
Zip	:	50219-7941
Country	:	US
Telephone Number	:	641-621-1401
Fax Number	:	614-628-7308

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MR. DENNIS DUANE VOGEL
Credential	:	PT
Telephone Number	:	641-624-1401

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	08/22/2020

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Directions to “PELLA HEALTH & FITNESS PC ” Practice Location

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