MEDICARE: ENRICHMENT THERAPIES PC

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
1	252Y00000X	Early Intervention Provider Agency	002093	IA

General Provider Information

NPI Number	:	1528356466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENRICHMENT THERAPIES PC

Provider Business Mailing Address
First Line	:	1035 PRAIRIE GRASS LN
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52246-8714
Country	:	US
Telephone Number	:	319-621-1137
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 5TH ST STE 102
Second Line	:
City	:	CORALVILLE
State	:	IA
Zip	:	52241-2904
Country	:	US
Telephone Number	:	319-358-6323
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. SONIA JOY CULVER
Credential	:
Telephone Number	:	319-621-1137

Provider Enumeration Date	:	07/13/2011
Last Update Date	:	03/07/2013

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Directions to “ENRICHMENT THERAPIES PC ” Practice Location

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