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General NPI Number Information
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NPI Number | 1063356160
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Entity Type | Organization
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Legal Business Name | IMMERSIVE MEDICAL THERAPY
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Dates
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Enumeration Date | 04/17/2026
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Last Update Date | 04/17/2026
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Provider Practice Location Address
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Address Line | 1830 HIGHWAY 1
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City | WASHINGTON
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State | IA
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Zip | 52353-9259
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Country | US
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Telephone | 319-333-4354
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Fax |
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Provider Business Mailing Address
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Address Line | 120 E MAIN ST # 10
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City | WASHINGTON
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State | IA
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Zip | 52353-2057
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Country | US
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Telephone | 319-333-4354
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LINDSEY VAN DUYN
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Credential | DO
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Telephone | 319-333-4354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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