Organization
COMMUNITY REHAB OF IOWA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP D DAVIDSON PT (OWNER)
(402) 614-7775
Entity
Organization
Contact information
Practice address
2410 E 7TH ST, #100, ATLANTIC, IA 50022-1961
(712) 243-2267
(712) 243-2671
Mailing address
2410 E 7TH ST, #100, ATLANTIC, IA 50022-1961
(712) 243-2267
(712) 243-2671
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN7419
RR MEDICARE
IA
01
—
PENDING
IOWA MEDICAID
IA
Enumeration date
01/19/2014
Last updated
04/21/2014
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