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Organization

21ST CENTURY REHAB PC

Active
Parent organization
21ST CENTURY REHAB PC
Other names
Indianola Physical Therapy
Organization subpart
Yes

Provider details

NPI number
Legal business name
21ST CENTURY REHAB PC
Authorized official
MICHELLE R CASSABAUM (CFO)
(515) 382-3366
Entity
Organization

Contact information

Practice address
1507 N 1ST ST, INDIANOLA, IA 50125-3703
(515) 961-7435
(515) 961-7436
Mailing address
PO BOX 461, NEVADA, IA 50201-0461
(515) 382-3366
(515) 382-1576

Taxonomy

Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0665810
IA
01
36587
WELLMARK BCBS
IA
Enumeration date
06/10/2008
Last updated
02/27/2025
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