Healthcare Provider Details

I. General information

NPI: 1659964880
Provider Name (Legal Business Name): AUSTIN KREBER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2021
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 W BRIDGE RD STE A
POLK CITY IA
50226-2308
US

IV. Provider business mailing address

850 43RD AVE STE 100
MOLINE IL
61265-8401
US

V. Phone/Fax

Practice location:
  • Phone: 515-984-6377
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: