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General NPI Number Information
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NPI Number | 1578689741
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Entity Type | Individual
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Provider Name | THOMAS R RODEMYER PT
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Gender | Male
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 1705 N ANKENY BLVD STE A
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City | ANKENY
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State | IA
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Zip | 50023-4168
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Country | US
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Telephone | 515-964-2559
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Fax | 515-964-2593
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Provider Business Mailing Address
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Address Line | 850 43RD AVE SUITE 100
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City | MOLINE
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State | IL
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Zip | 61265-8401
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Country | US
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Telephone | 309-743-2070
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Fax | 309-743-2073
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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 | 04027
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License Number State | IA
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