Individual
KEYRON NICK LAUBENTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CO, PT
Contact information
Practice address
540 E JEFFERSON ST, SUITE 302, IOWA CITY, IA 52245-2477
(319) 339-3611
(319) 339-3878
Mailing address
2401 TOWNCREST DR, IOWA CITY, IA 52240-6631
(319) 354-2429
(319) 354-6100
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
00301
IA
225100000X
Physical Therapist
Primary
00301
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0665463
—
IA
Enumeration date
09/16/2008
Last updated
09/16/2008
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