# COMMUNITY REHAB OF IOWA LLC

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

## Provider details

- **NPI number:** 1316369770
- **Authorized official:** PHILIP D DAVIDSON PT (OWNER)
- **Authorized official phone:** (402) 614-7775

## Contact information

- **Practice address:** 2410 E 7TH ST, \#100, ATLANTIC, IA 50022-1961
- **Practice address phone:** (712) 243-2267
- **Practice address fax:** (712) 243-2671
- **Mailing address:** 2410 E 7TH ST, \#100, ATLANTIC, IA 50022-1961
- **Mailing address phone:** (712) 243-2267
- **Mailing address fax:** (712) 243-2671

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 01/19/2014
- **Last updated:** 04/21/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | DN7419 | RR MEDICARE | IA |
| 01 | — | PENDING | IOWA MEDICAID | IA |