| Organization Name: | BLUEPRINT PEDIATRIC THERAPY, PLC |
| NPI Number: | 1669877056 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RACHEL LYNN KONGSHAUG (OWNER) |
| Mailing Address: | 2387 Mehaffey Bridge Rd Ne North Liberty |
| State: | IA US |
| Postal Code: | 523179348 |
| Phone Number: | 3193334490 |
| Fax Number: | |
| NPI Enumeration Date: | 10/27/2014 |
| NPI Last Update Date: | 10/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 3530 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |