# MLG PHYSICAL THERAPY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Active Performance Physical Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366854846
- **Authorized official:** MARY LOUISE GALLEGOS MPT (OWNER/ PHYSICAL THERAPIST)
- **Authorized official phone:** (317) 557-2334

## Contact information

- **Practice address:** 1824 HIGHWAY 30 E, DENISON, IA 51442-2101
- **Practice address phone:** (712) 393-7000
- **Practice address fax:** (712) 393-7001
- **Mailing address:** PO BOX 455, CARROLL, IA 51401-0455
- **Mailing address phone:** (712) 393-7000
- **Mailing address fax:** (712) 393-7001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/02/2014
- **Last updated:** 06/17/2014