Healthcare Provider Details

I. General information

NPI: 1265633630
Provider Name (Legal Business Name): MARILYN D MUHLE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 6TH ST SW GWAEA
CEDAR RAPIDS IA
52404
US

IV. Provider business mailing address

109 OREOLE DR NE
SOLON IA
52333-9087
US

V. Phone/Fax

Practice location:
  • Phone: 319-399-6857
  • Fax:
Mailing address:
  • Phone: 319-624-1559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number811
License Number StateIA

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: