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NPI Code Detail

MEDICARE: JILL BIRKS RPT

MEDICARE: JILL BIRKS RPT
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 Therapist01887IA

General Provider Information

NPI Number : 1609077973
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL BIRKS RPT
Provider Business Mailing Address
First Line : 2644 HARRIS AVENUE
Second Line :
City : ROCKWELL CITY
State : IA
Zip : 50579
Country : US
Telephone Number : 712-297-5228
Fax Number :
Provider Business Practice Location Address
First Line : 135 WARNER ST
Second Line :
City : ROCKWELL CITY
State : IA
Zip : 50579-1722
Country : US
Telephone Number : 615-896-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2007
Last Update Date : 07/08/2007

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Directions to “ JILL BIRKS RPT” Practice Location

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