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NPI Code Detail

MEDICARE: SUNNYBROOK PHYSICIANS AND REHAB GROPUP PC

MEDICARE: SUNNYBROOK PHYSICIANS AND REHAB GROPUP 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
1111N00000XChiropractor
2208D00000XGeneral Practice Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11164402210OTHERIANPI
21487634259OTHERIANPI
31952380750OTHERIANPI
41487633285OTHERIANPI

General Provider Information

NPI Number : 1891933784
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNNYBROOK PHYSICIANS AND REHAB GROPUP PC
Provider Business Mailing Address
First Line : 5740 SUNNYBROOK DR
Second Line :
City : SIOUX CITY
State : IA
Zip : 51106-4249
Country : US
Telephone Number : 712-274-1019
Fax Number : 712-274-8909
Provider Business Practice Location Address
First Line : 5740 SUNNYBROOK DRIVE
Second Line :
City : SIOUX CITY
State : IA
Zip : 51106-4249
Country : US
Telephone Number : 712-274-1019
Fax Number : 712-274-8909
Authorized Official
Title or Position : PRESIDENT
Name : DR. PAT E LUSE
Credential : D.C.
Telephone Number : 712-274-1019
Provider Enumeration Date : 01/30/2009
Last Update Date : 01/30/2009

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Directions to “SUNNYBROOK PHYSICIANS AND REHAB GROPUP PC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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