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General NPI Number Information
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NPI Number | 1700986304
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Entity Type | Organization
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Legal Business Name | TOTAL REHAB-ORTHOPEDIC AND SPORTS SPECIALIST, P.C.
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 234 WEST ST S SOUTHVIEW PLAZA SUITE #4
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City | GRINNELL
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State | IA
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Zip | 50112-8160
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Country | US
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Telephone | 641-236-4506
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Fax | 641-236-4316
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Provider Business Mailing Address
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Address Line | 234 WEST ST S SOUTHVIEW PLAZA SUITE #4
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City | GRINNELL
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State | IA
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Zip | 50112-8160
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Country | US
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Telephone | 641-236-4506
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Fax | 641-236-4316
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | MRS. STACEY A ALBERTS
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Credential | PT
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Telephone | 641-236-4506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1432
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 04029
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 004152
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License Number State | IA
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3382
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License Number State | IA
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