MEDICARE: LAURA WERSTEIN PTA

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	225200000X	Physical Therapy Assistant	00903	IA

General Provider Information

NPI Number	:	1356739445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA WERSTEIN PTA

Provider Business Mailing Address
First Line	:	6255 BEECHTREE DR
Second Line	:	UNIT 5204
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-8699
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6255 BEECHTREE DR
Second Line	:	UNIT 5204
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-8699
Country	:	US
Telephone Number	:	641-425-9861
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2014
Last Update Date	:	12/26/2014

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Directions to “ LAURA WERSTEIN PTA” Practice Location

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