MEDICARE: KING THERAPY SERVICES, LLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1922628999
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KING THERAPY SERVICES, LLC

Provider Business Mailing Address
First Line	:	1460 DOE RUN DR
Second Line	:
City	:	NORTH LIBERTY
State	:	IA
Zip	:	52317-9699
Country	:	US
Telephone Number	:	319-210-0222
Fax Number	:

Provider Business Practice Location Address
First Line	:	373 COLLINS RD NE STE 203
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-3167
Country	:	US
Telephone Number	:	319-210-0222
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JULIE KING
Credential	:	LISW
Telephone Number	:	319-210-0222

Provider Enumeration Date	:	04/20/2020
Last Update Date	:	04/20/2020

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Directions to “KING THERAPY SERVICES, LLC ” Practice Location

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