# VANTAGE REHAB INC

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

## Provider details

- **NPI number:** 1922358175
- **Authorized official:** LESLI NORDHUES OT (OWNER/OT)
- **Authorized official phone:** (712) 303-9948

## Contact information

- **Practice address:** 500 N BROAD ST, SHENANDOAH, IA 51601-1318
- **Practice address phone:** (712) 246-2268
- **Practice address fax:** (712) 246-2110
- **Mailing address:** 500 N BROAD ST, SHENANDOAH, IA 51601-1318
- **Mailing address phone:** (712) 246-2268
- **Mailing address fax:** (712) 246-2110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 01774 | IA | Yes |

## Other

- **Enumeration date:** 09/14/2012
- **Last updated:** 11/02/2012