Healthcare Provider Details

I. General information

NPI: 1083832323
Provider Name (Legal Business Name): PHYSIOTHERAPY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 7TH ST SE
CEDAR RAPIDS IA
52401-2112
US

IV. Provider business mailing address

4700 TAMA ST SE SUITE 700
CEDAR RAPIDS IA
52403-4556
US

V. Phone/Fax

Practice location:
  • Phone: 319-398-1793
  • Fax:
Mailing address:
  • Phone: 319-447-0700
  • Fax: 319-447-0808

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:

# 1
Identifier0665430
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name: ROB ZIGENFUS
Title or Position: CONTRACTING
Credential:
Phone: 901-685-7227