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General NPI Number Information
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NPI Number | 1700412848
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Entity Type | Organization
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Legal Business Name | HOME TEAM WELLNESS AND RECOVERY, LLC
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Dates
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Enumeration Date | 03/20/2020
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 2721 STANGE RD STE 108
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City | AMES
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State | IA
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Zip | 50010-3978
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Country | US
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Telephone | 515-207-0172
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Fax |
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Provider Business Mailing Address
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Address Line | 3038 REDBUD CIR
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City | AMES
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State | IA
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Zip | 50014-4518
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Country | US
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Telephone | 515-708-4940
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | MEGAN MAUREEN BURT
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Credential | PT, DPT
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Telephone | 515-207-0172
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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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