# PHYSICAL THERAPY AND REHABILITATION SPECIALIST INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104904168
- **Authorized official:** CAROLYN MCVAY (OFFICE MANAGER)
- **Authorized official phone:** (515) 993-3517

## Contact information

- **Practice address:** 1205 GREENE ST, ADEL, IA 50003-1715
- **Practice address phone:** (515) 993-3517
- **Practice address fax:** (515) 993-5473
- **Mailing address:** 1205 GREENE ST, ADEL, IA 50003-1715
- **Mailing address phone:** (515) 993-3517
- **Mailing address fax:** (515) 993-5473

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225400000X | Rehabilitation Practitioner | — | NULL | Yes |
| 225400000X | Rehabilitation Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0665042 | — | IA |
| 01 | — | 66504 | BLUE CROSS | IA |