Individual
TROY MICHAEL MCDONOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.P.T.
Contact information
Practice address
1215 DUFF AVE, AMES, IA 50010-5400
(515) 956-4095
(515) 956-4093
Mailing address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(630) 575-6200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
005262
IA
2251X0800X
Orthopedic Physical Therapist
1768PT
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000344097
—
MT
01
—
000060776
BLUE CROSS FOR SEELY LAKE
MT
01
—
00006175
BLUE CROSS
MT
Enumeration date
06/26/2007
Last updated
08/05/2015
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