Healthcare Provider Details
I. General information
NPI: 1255385852
Provider Name (Legal Business Name): MILLENNIUM REHAB & CONSULTING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/19/2006
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4725 MERLE HAY RD SUITE 101
DES MOINES IA
50322-1983
US
IV. Provider business mailing address
4725 MERLE HAY RD STE 207
DES MOINES IA
50322-1983
US
V. Phone/Fax
- Phone: 515-221-2220
- Fax: 515-221-2700
- Phone: 515-331-3190
- Fax: 515-331-3191
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TAMMY
LYNN
CHAPMAN
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 515-331-3190