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Organization
ORTHO SPINE & PAIN CLINIC LLC
Active
Organization
ORTHO SPINE & PAIN CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN LOUW MPT (OWNER)
(515) 733-2699
Entity
Organization
Contact information
Practice address
618 BROAD ST, SUITE A, STORY CITY, IA 50248-1255
(208) 467-9117
(515) 733-2744
Mailing address
2965 E TARPON DR, SUITE 150, MERIDIAN, ID 83642-9009
(515) 733-2707
(515) 733-2744
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004383
NULL
225100000X
Physical Therapist
Primary
004383
—
2251N0400X
Neurology Physical Therapist
004383
IA
2251X0800X
Orthopedic Physical Therapist
—
NULL
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Enumeration date
11/10/2010
Last updated
04/30/2013
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