Individual
TAYLOR MITACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
241 SE DESTINATION DR, GRIMES, IA 50111-1247
(515) 986-5190
(515) 986-5194
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
123558
IA
Other
Enumeration date
01/26/2018
Last updated
01/23/2024
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