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General NPI Number Information
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NPI Number | 1720847452
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Entity Type | Organization
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Legal Business Name | LIGHTNING REHABILITATION & FITNESS PLLC
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Dates
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Enumeration Date | 03/15/2024
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 2280 PEORIA AVENUE
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City | SPIRIT LAKE
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State | IA
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Zip | 51360
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Country | US
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Telephone | 319-759-6620
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Fax |
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Provider Business Mailing Address
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Address Line | 2280 PEORIA AVENUE
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City | SPIRIT LAKE
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State | IA
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Zip | 51360
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Country | US
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Telephone | 319-759-6620
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TYLER ROGERS
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Credential |
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Telephone | 319-759-6620
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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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