Healthcare Provider Details

I. General information

NPI: 1548209349
Provider Name (Legal Business Name): JENNIFER A. HANDLOS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 N MAIN ST
CARROLL IA
51401-2739
US

IV. Provider business mailing address

1352 N U.S. 71
CARROLL IA
51401
US

V. Phone/Fax

Practice location:
  • Phone: 712-792-0040
  • Fax: 712-215-7393
Mailing address:
  • Phone: 712-792-0040
  • Fax: 712-215-7393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number02754
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: