Healthcare Provider Details

I. General information

NPI: 1285303313
Provider Name (Legal Business Name): VAASSEN HOME PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2021
Last Update Date: 09/14/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9843 KATIE CV
DUBUQUE IA
52003-8476
US

IV. Provider business mailing address

9843 KATIE CV
DUBUQUE IA
52003-8476
US

V. Phone/Fax

Practice location:
  • Phone: 563-663-7004
  • Fax:
Mailing address:
  • Phone: 563-663-7004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MADELINE M VAASSEN
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT, GCS, CLT
Phone: 563-663-7004