Individual
MR. AUSTIN ALAN ISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2740 1ST AVE NE, #1, CEDAR RAPIDS, IA 52402-4856
(319) 398-6034
Mailing address
201 N 78TH ST, KANSAS CITY, KS 66112
(913) 226-9231
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-04469
KS
225100000X
Physical Therapist
2012025073
MO
225100000X
Physical Therapist
—
—
Other
Enumeration date
07/31/2012
Last updated
11/12/2021
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