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Organization

SPORTS REHAB & PROFESSIONAL THERAPY ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TODD D NICHOLSON PHYSICAL THERAPIST (PRESIDENT PHYSICAL THERAPIST)
(712) 732-7725
Entity
Organization

Contact information

Practice address
315 W 5TH ST, STORM LAKE, IA 50588-1743
(712) 732-7725
(712) 732-5153
Mailing address
315 W 5TH ST, STORM LAKE, IA 50588-1743
(712) 732-7725
(712) 732-5153

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
M096051
IA
332BC3200X
Customized Equipment (DME)
Primary
M096051
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0118984
IA
Enumeration date
02/02/2007
Last updated
09/11/2025
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