Healthcare Provider Details

I. General information

NPI: 1922628999
Provider Name (Legal Business Name): KING THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2020
Last Update Date: 04/20/2020
Certification Date: 04/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

373 COLLINS RD NE STE 203
CEDAR RAPIDS IA
52402-3167
US

IV. Provider business mailing address

1460 DOE RUN DR
NORTH LIBERTY IA
52317-9699
US

V. Phone/Fax

Practice location:
  • Phone: 319-210-0222
  • Fax:
Mailing address:
  • Phone: 319-210-0222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
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: JULIE KING
Title or Position: OWNER
Credential: LISW
Phone: 319-210-0222