# RATHBUN LAKE AREA YOUNG MENS CHRISTIAN ASSOCIATION

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

## Provider details

- **NPI number:** 1356619555
- **Authorized official:** RANDY GROFF (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (641) 437-1977

## Contact information

- **Practice address:** 708 S MAIN ST, CENTERVILLE, IA 52544-2422
- **Practice address phone:** (641) 437-1977
- **Practice address fax:** (641) 437-1976
- **Mailing address:** PO BOX 71602, CLIVE, IA 50325-0602
- **Mailing address phone:** (515) 243-2057
- **Mailing address fax:** (515) 244-5570

## Taxonomy

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

## Other

- **Enumeration date:** 12/02/2011
- **Last updated:** 05/31/2012