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NPI Code Detail

MEDICARE: MR. DOUGLAS BRIAN KEISER M.P.T.

MEDICARE: MR. DOUGLAS BRIAN KEISER M.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 Therapist01593IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
154448OTHERIAWELLMARK BC/BS OF IOWA

General Provider Information

NPI Number : 1528060282
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DOUGLAS BRIAN KEISER M.P.T.
Provider Business Mailing Address
First Line : PO BOX 1107
Second Line :
City : CEDAR FALLS
State : IA
Zip : 50613-0049
Country : US
Telephone Number : 319-277-3166
Fax Number : 319-266-4846
Provider Business Practice Location Address
First Line : 211 W 6TH ST
Second Line :
City : CEDAR FALLS
State : IA
Zip : 50613-2859
Country : US
Telephone Number : 319-277-3166
Fax Number : 319-266-4846
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2005
Last Update Date : 07/08/2007

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