Individual
MR. CALVIN DEAN RUNNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
301 N ANKENY BLVD SUITE 200, ANKENY PHYSICAL SPORTS THERAPY, ANKENY, IA 50021
(515) 965-1422
(515) 965-1449
Mailing address
301 N ANKENY BLVD SUITE 200, ANKENY PHYSICAL SPORTS THERAPY, ANKENY, IA 50021
(515) 965-1422
(515) 965-1449
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
00651
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0166547
—
IA
Enumeration date
03/27/2006
Last updated
07/08/2007
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