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General NPI Number Information
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NPI Number | 1760670426
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Entity Type | Organization
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Legal Business Name | FIT 4 GOLF, LLC DBA ADVANCED PHYSICAL THERAPY AND MASSAGE
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 03/05/2012
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Provider Practice Location Address
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Address Line | 359 N 1ST AVE
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City | IOWA CITY
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State | IA
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Zip | 52245-3618
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Country | US
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Telephone | 319-350-9616
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Fax | 319-624-5273
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Provider Business Mailing Address
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Address Line | 359 N 1ST AVE
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City | IOWA CITY
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State | IA
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Zip | 52245-3618
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Country | US
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Telephone | 319-350-9616
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Fax | 319-624-5273
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SUE ELLEN BRANSKY
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Credential | P.T.
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Telephone | 319-350-9616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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