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General NPI Number Information
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NPI Number | 1487773602
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Entity Type | Organization
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Legal Business Name | PROACTIVE PHYSICAL THERAPY & SPORTS REHAB, INC
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 09/24/2015
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Provider Practice Location Address
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Address Line | 110 16TH ST SW
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City | SIOUX CENTER
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State | IA
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Zip | 51250-2944
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Country | US
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Telephone | 712-722-1902
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Fax | 712-722-1905
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Provider Business Mailing Address
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Address Line | 110 16TH ST NW
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City | SIOUX CENTER
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State | IA
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Zip | 51250-1535
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Country | US
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Telephone | 712-722-1902
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Fax | 712-722-1905
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Authorized Official
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Title or Position | CO-OWNER
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Name | JULIE ARENDS
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Credential | MPT
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Telephone | 712-722-1902
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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 |
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License Number State |
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