Healthcare Provider Details

I. General information

NPI: 1386985364
Provider Name (Legal Business Name): EURO TEAM PHYSICAL THERAPY CLINIC,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2013
Last Update Date: 03/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 172ND AVE # 1
DECORAH IA
52101-7584
US

IV. Provider business mailing address

2345 172ND AVE # 1
DECORAH IA
52101-7584
US

V. Phone/Fax

Practice location:
  • Phone: 563-277-1059
  • Fax: 563-277-1022
Mailing address:
  • Phone: 563-277-1059
  • Fax: 563-277-1022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number01840
License Number StateIA

VII. Legacy identifiers

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

VIII. Authorized Official

Name: LISA BC KRIEG
Title or Position: MPT/OWNER
Credential: MPT
Phone: 563-277-1059