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General NPI Number Information
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NPI Number | 1912987108
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY PARTNERS
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 06/03/2010
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Provider Practice Location Address
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Address Line | 815 TOWER PARK DR
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City | WATERLOO
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State | IA
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Zip | 50701-9026
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Country | US
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Telephone | 319-233-6995
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Fax | 319-233-7083
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Provider Business Mailing Address
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Address Line | 815 TOWER PARK DR
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City | WATERLOO
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State | IA
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Zip | 50701-9026
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Country | US
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Telephone | 319-233-6995
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Fax | 319-233-7083
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Authorized Official
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Title or Position | PARTNER
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Name | AMY KIMBALL
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Credential | PT, ATC
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Telephone | 319-233-6995
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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 | 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 | 02905
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License Number State | IA
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