Healthcare Provider Details

I. General information

NPI: 1659276848
Provider Name (Legal Business Name): WHOLE HEART THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 B AVE
KALONA IA
52247-0000
US

IV. Provider business mailing address

1580 480TH ST SW
KALONA IA
52247-9243
US

V. Phone/Fax

Practice location:
  • Phone: 319-214-9129
  • Fax:
Mailing address:
  • Phone: 319-530-3788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: BETHANY ROBERTS
Title or Position: SOLE OWNER/CLINICIAN
Credential: LISW
Phone: 319-530-3788