# GREAT LAKES PHYSICAL THERAPY, PC

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

## Provider details

- **NPI number:** 1740593599
- **Authorized official:** MR. DAVID J HALLAND P.T. (PHYSICAL THERAPIST)
- **Authorized official phone:** (712) 320-2722

## Contact information

- **Practice address:** 2714 CENTER LAKE DR, SPIRIT LAKE, IA 51360-7268
- **Practice address phone:** (712) 320-2722
- **Mailing address:** 2714 CENTER LAKE DR, SPIRIT LAKE, IA 51360-7268
- **Mailing address phone:** (712) 320-2722

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 055168 | IA | Yes |

## Other

- **Enumeration date:** 07/22/2010
- **Last updated:** 07/22/2010