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General NPI Number Information
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NPI Number | 1639036288
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Entity Type | Individual
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Provider Name | COLTON VANDER BERG DPT
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Gender | Male
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 3600 UNIVERSITY BLVD STE 101
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City | AMES
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State | IA
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Zip | 50010-8674
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Country | US
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Telephone | 515-239-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 8655 BRIDGEWOOD BLVD APT 7216
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City | WEST DES MOINES
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State | IA
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Zip | 50266-8269
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Country | US
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Telephone | 262-502-7068
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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 |
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License Number State |
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