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NPI Code Detail

MEDICARE: MS. JEAN LORIE NOLLEN P.T.

MEDICARE: MS. JEAN LORIE NOLLEN P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist01043IA

General Provider Information

NPI Number : 1073782801
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JEAN LORIE NOLLEN P.T.
Provider Business Mailing Address
First Line : 1307 S BROADWAY ST
Second Line : TOLEDO REHAB CENTER
City : TOLEDO
State : IA
Zip : 52342-2307
Country : US
Telephone Number : 641-484-5253
Fax Number : 641-484-5312
Provider Business Practice Location Address
First Line : 1307 S BROADWAY ST
Second Line : TOLEDO REHAB CENTER
City : TOLEDO
State : IA
Zip : 52342-2307
Country : US
Telephone Number : 641-484-5253
Fax Number : 641-484-5312
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2008
Last Update Date : 10/11/2012

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