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General NPI Number Information
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NPI Number | 1851864557
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Entity Type | Organization
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Legal Business Name | SYNERGIST, LLC
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Dates
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Enumeration Date | 01/04/2019
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Last Update Date | 01/04/2019
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Provider Practice Location Address
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Address Line | 1082 CEDAR CROSS RD
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City | DUBUQUE
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State | IA
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Zip | 52003-7745
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Country | US
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Telephone | 563-543-4049
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Fax |
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Provider Business Mailing Address
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Address Line | 9498 GINGER DR
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City | PEOSTA
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State | IA
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Zip | 52068-8088
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Country | US
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Telephone | 563-543-4049
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BENJAMIN M MAIERS
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Credential | DPT
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Telephone | 563-543-4049
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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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