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Organization
ADVANTAGE PHYSICAL THERAPY & REHAB, INC.
Active
Organization
ADVANTAGE PHYSICAL THERAPY & REHAB, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES E GOODHUE MSPT (PARTNER/PHYSICAL THERAPIST)
(515) 276-1111
Entity
Organization
Contact information
Practice address
7564 HICKMAN ROAD, DES MOINES, IA 50324-4621
(515) 276-1111
(515) 864-0391
Mailing address
2213 GRAND AVENUE, DES MOINES, IA 50312-5305
(515) 237-3974
(515) 883-2692
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02018
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750691572
—
IA
01
—
615606502
OWCP
—
01
—
DT2836
RAILROAD MEDICARE
IA
Enumeration date
10/14/2010
Last updated
05/23/2016
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