# INTEGRATION PHYSICAL THERAPY, LLC

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

## Provider details

- **NPI number:** 1558619049
- **Authorized official:** JANE A STANLEY M.P.T., P.R.C. (DIRECTOR/OWNER)
- **Authorized official phone:** (712) 490-3494

## Contact information

- **Practice address:** 3450 S LAKEPORT ST STE B, SIOUX CITY, IA 51106-4543
- **Practice address phone:** (712) 276-2906
- **Practice address fax:** (712) 276-3090
- **Mailing address:** 3450 S LAKEPORT ST STE B, SIOUX CITY, IA 51106-4543
- **Mailing address phone:** (712) 276-2906
- **Mailing address fax:** (712) 276-3090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 02786 | IA | Yes |

## Other

- **Enumeration date:** 08/15/2012
- **Last updated:** 08/15/2012