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NPI Code Detail

MEDICARE: MRS. CHRISTINE MARIE MCCUSKER PT

MEDICARE: MRS. CHRISTINE MARIE MCCUSKER PT
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 Therapist03833IA

General Provider Information

NPI Number : 1891991790
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTINE MARIE MCCUSKER PT
Provider Business Mailing Address
First Line : 94 HERON CIR
Second Line :
City : IOWA CITY
State : IA
Zip : 52245-4122
Country : US
Telephone Number : 319-354-0006
Fax Number :
Provider Business Practice Location Address
First Line : 3661 ROCHESTER AVE
Second Line :
City : IOWA CITY
State : IA
Zip : 52245-9271
Country : US
Telephone Number : 319-351-7460
Fax Number : 319-341-6229
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2007
Last Update Date : 07/08/2007

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