Organization
CLINTON PHYSICAL THERAPY SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY D. VANDE KAMP P.T. (PRESIDENT)
(563) 357-0305
Entity
Organization
Contact information
Practice address
240 N BLUFF BLVD STE 101, CLINTON, IA 52732-7146
(563) 243-1642
(563) 243-8329
Mailing address
240 N BLUFF BLVD STE 101, P.O. BOX 337, CLINTON, IA 52732-7146
(563) 243-1642
(563) 243-8329
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0111013
MEDICAID DME
IA
05
—
0271825
—
IA
05
—
1271825
—
IA
Enumeration date
08/11/2006
Last updated
11/23/2011
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