=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417841651
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CALEB JAY HARMSEN PT, DPT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2025
-----------------------------------------------------
Last Update Date | 06/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1101 9TH ST SE
-----------------------------------------------------
City | SIOUX CENTER
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 51250-2501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 712-722-1271
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2460 390TH ST
-----------------------------------------------------
City | SIOUX CENTER
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 51250-7580
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 132804
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------