Organization
VANTAGE REHAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLI NORDHUES OT (OWNER/OT)
(712) 303-9948
Entity
Organization
Contact information
Practice address
500 N BROAD ST, SHENANDOAH, IA 51601-1318
(712) 246-2268
(712) 246-2110
Mailing address
500 N BROAD ST, SHENANDOAH, IA 51601-1318
(712) 246-2268
(712) 246-2110
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
01774
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568643237
NPI
IA
01
—
1811265366
NPI
IA
Enumeration date
09/14/2012
Last updated
11/02/2012
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