Healthcare Provider Details

I. General information

NPI: 1114613080
Provider Name (Legal Business Name): CIERA STITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 CORPORATE DR STE R
JOHNSTON IA
50131-1659
US

IV. Provider business mailing address

8805 CHAMBERY BLVD STE 300-237
JOHNSTON IA
50131-8813
US

V. Phone/Fax

Practice location:
  • Phone: 515-220-1365
  • Fax:
Mailing address:
  • Phone: 515-220-1365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number117116
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: