# ADVANTAGE PHYSICAL THERAPY & REHAB, INC.

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

## Provider details

- **NPI number:** 1750691572
- **Authorized official:** CHARLES E GOODHUE MSPT (PARTNER/PHYSICAL THERAPIST)
- **Authorized official phone:** (515) 276-1111

## Contact information

- **Practice address:** 7564 HICKMAN ROAD, DES MOINES, IA 50324-4621
- **Practice address phone:** (515) 276-1111
- **Practice address fax:** (515) 864-0391
- **Mailing address:** 2213 GRAND AVENUE, DES MOINES, IA 50312-5305
- **Mailing address phone:** (515) 237-3974
- **Mailing address fax:** (515) 883-2692

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 02018 | IA | Yes |

## Other

- **Enumeration date:** 10/14/2010
- **Last updated:** 05/23/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1750691572 | — | IA |
| 01 | — | 615606502 | OWCP | — |
| 01 | — | DT2836 | RAILROAD MEDICARE | IA |