Healthcare Provider Details

I. General information

NPI: 1528934528
Provider Name (Legal Business Name): SPECTRUM THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4033 LARKSPUR DR
MARION IA
52302-4890
US

IV. Provider business mailing address

4033 LARKSPUR DR
MARION IA
52302-4890
US

V. Phone/Fax

Practice location:
  • Phone: 319-743-8561
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code226000000X
TaxonomyRecreational Therapist Assistant
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH LOUISON
Title or Position: ADMINISTRATOR
Credential:
Phone: 319-743-8561