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NPI Code Detail

MEDICARE: DR. MARY ANN IRELAND PT, DPT

MEDICARE: DR. MARY ANN IRELAND PT, DPT
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
1225100000XPhysical Therapist4993IA

General Provider Information

NPI Number : 1619222569
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY ANN IRELAND PT, DPT
Provider Business Mailing Address
First Line : 4614 84TH ST
Second Line :
City : URBANDALE
State : IA
Zip : 50322-1089
Country : US
Telephone Number : 515-270-6838
Fax Number :
Provider Business Practice Location Address
First Line : 4614 84TH ST
Second Line :
City : URBANDALE
State : IA
Zip : 50322-1089
Country : US
Telephone Number : 515-270-6838
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2012
Last Update Date : 07/17/2012

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