Healthcare Provider Details
I. General information
NPI: 1023996592
Provider Name (Legal Business Name): IMARA PERFORMANCE PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/23/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8800 COUNTY LINE RD
CUMMING IA
50061-5826
US
IV. Provider business mailing address
8800 COUNTY LINE RD
CUMMING IA
50061-5826
US
V. Phone/Fax
- Phone: 515-612-6420
- Fax:
- Phone: 515-298-1522
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DANNA
KELLY
HERRICK
Title or Position: OWNER/FOUNDER
Credential: PT, DPT
Phone: 515-298-1522