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General NPI Number Information
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NPI Number | 1962081091
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Entity Type | Organization
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Legal Business Name | PROPRIOCEPTION INC
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Dates
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Enumeration Date | 04/06/2021
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Last Update Date | 04/14/2021
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Provider Practice Location Address
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Address Line | 2675 N ANKENY BLVD STE 113
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City | ANKENY
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State | IA
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Zip | 50023-4719
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Country | US
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Telephone | 515-289-4549
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Fax |
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Provider Business Mailing Address
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Address Line | 2675 N ANKENY BLVD STE 113
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City | ANKENY
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State | IA
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Zip | 50023-4719
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Country | US
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Telephone | 515-289-4549
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | TAYLOR VANDEN WYNBOOM
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Credential |
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Telephone | 515-289-4549
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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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