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General NPI Number Information
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NPI Number | 1780464305
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Entity Type | Organization
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Legal Business Name | ENDURO LLC
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Dates
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Enumeration Date | 10/02/2023
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 1520 NW IRVINEDALE DR STE 103
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City | ANKENY
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State | IA
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Zip | 50023-7429
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Country | US
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Telephone | 515-718-7177
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Fax |
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Provider Business Mailing Address
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Address Line | 3101 SE MAGNOLIA DR
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City | ANKENY
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State | IA
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Zip | 50021-9586
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, PHYSICAL THERAPIST
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Name | KAYLA DEIGHAN
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Credential |
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Telephone | 316-259-4979
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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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