Healthcare Provider Details

I. General information

NPI: 1336193986
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

2300 SWAN LAKE BLVD SUITE 103
INDEPENDENCE IA
50644-9708
US

IV. Provider business mailing address

4725 MERLE HAY RD STE 207
DES MOINES IA
50322-1983
US

V. Phone/Fax

Practice location:
  • Phone: 319-334-5155
  • Fax: 319-334-6166
Mailing address:
  • Phone: 515-331-3190
  • Fax: 515-331-3191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HOLLY LITTLE
Title or Position: COO
Credential:
Phone: 515-331-3190