Organization
CLINTON PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY D VANDE KAMP P.T. (PRESIDENT)
(563) 357-0305
Entity
Organization
Contact information
Practice address
240 N BLUFF BLVD, SUITE 101, CLINTON, IA 52732-7146
(563) 242-4422
(563) 243-8329
Mailing address
240 N BLUFF BLVD, SUITE 101, CLINTON, IA 52732-7146
(563) 242-4422
(563) 243-8329
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0111013
MEDICAID DME
IA
Enumeration date
11/08/2007
Last updated
04/14/2008
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