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General NPI Number Information
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NPI Number | 1013039015
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Entity Type | Individual
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Provider Name | PEGGY JO ROLING PT
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Gender | Female
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 301 NE TRILEIN DR SUITE 4
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City | ANKENY
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State | IA
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Zip | 50021-2170
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Country | US
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Telephone | 515-965-7682
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Fax |
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Provider Business Mailing Address
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Address Line | 829 LAWTHER ST
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City | DUBUQUE
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State | IA
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Zip | 52001-8136
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Country | US
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Telephone | 563-582-0901
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 02769
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 6278-024
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License Number State | WI
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