| Doctor Name: | LAUREN WETTACH |
| NPI Number: | 1639593783 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | 005302 |
| Business Practice Address: | 3385 Dexter Ct Ste. 203 Davenport, IA - 528073494 |
| Business Phone Number: | 5633329312 |
| Business Fax Number: | 5633329316 |
| Mailing Address: | 850 43rd Ave, Ste. 100 MOLINE |
| State: | IL |
| Postal Code: | 612658401 |
| Phone Number: | 3097432070 |
| Fax Number: | 3097432073 |
| NPI Enumeration Date: | 02/10/2014 |
| NPI Last Update Date: | 03/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 005302 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |