Healthcare Provider Details

I. General information

NPI: 1780492181
Provider Name (Legal Business Name): EVOLVE PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2024
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 E STATE ST
ALGONA IA
50511-2840
US

IV. Provider business mailing address

224 E OAK ST
ALGONA IA
50511-1537
US

V. Phone/Fax

Practice location:
  • Phone: 913-787-5687
  • Fax:
Mailing address:
  • Phone: 913-787-5687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: AUDREY FINER
Title or Position: OWNER
Credential: PT, DPT
Phone: 913-787-5687