Healthcare Provider Details

I. General information

NPI: 1679477822
Provider Name (Legal Business Name): NERVE CENTER OF IOWA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 NW 114TH ST STE 205
CLIVE IA
50325-7011
US

IV. Provider business mailing address

1370 NW 114TH ST STE 205
CLIVE IA
50325-7011
US

V. Phone/Fax

Practice location:
  • Phone: 515-612-1200
  • Fax: 515-347-8849
Mailing address:
  • Phone: 515-612-1200
  • Fax: 515-347-8849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: LOGAN MCCOOL
Title or Position: CEO
Credential: DO
Phone: 515-612-1200