# PHYSICAL MEDICINE & REHABILITATION ASSOCIATES OF NORTHEAST IOWA INC

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

## Provider details

- **NPI number:** 1659564664
- **Authorized official:** DR. FARID F MANSHADI MD (PRESIDENT)
- **Authorized official phone:** (319) 234-0109

## Contact information

- **Practice address:** 36 W PARK LANE, WATERLOO, IA 50701-5178
- **Practice address phone:** (319) 234-0109
- **Practice address fax:** (319) 234-5774
- **Mailing address:** 36 W PARK LN, WATERLOO, IA 50701-5178
- **Mailing address phone:** (319) 234-0109
- **Mailing address fax:** (319) 234-5774

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 27493 | IA | Yes |
| 363L00000X | Nurse Practitioner | J-054600 | IA | — |

## Other

- **Enumeration date:** 08/22/2007
- **Last updated:** 05/12/2014