Organization
SPORTS REHAB AND PROFESSIONAL THERAPY ASSOCIATES INC
Active
Other names
Sports Rehab & Professional Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA LYNN GODFREY (CLINIC ADMIN DIRECTOR)
(402) 334-6025
Entity
Organization
Contact information
Practice address
315 W 5TH ST, STORM LAKE, IA 50588-1743
(712) 732-7724
(712) 560-9253
Mailing address
315 W 5TH ST, STORM LAKE, IA 50588-1743
(712) 732-7724
(712) 732-5153
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0665141
—
IA
Enumeration date
11/09/2006
Last updated
04/18/2024
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