Healthcare Provider Details

I. General information

NPI: 1851832182
Provider Name (Legal Business Name): HOMETOWN PHYSICAL THERAPY HOLDING COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 04/08/2022
Certification Date: 04/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 W 6TH ST SUITE 101
SPENCER IA
51301-3901
US

IV. Provider business mailing address

20 W 6TH ST SUITE 101
SPENCER IA
51301-3901
US

V. Phone/Fax

Practice location:
  • Phone: 712-580-5008
  • Fax: 712-250-2415
Mailing address:
  • Phone: 712-580-5008
  • Fax: 712-546-1770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: SANDRA NORBY
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: DPT
Phone: 712-540-8849