Doctor Name: | RICHARD BRENT MONGAR |
NPI Number: | 1679877021 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 03688 |
Business Practice Address: | 12493 University Ave Clive, IA - 503258281 |
Business Phone Number: | 5156453350 |
Business Fax Number: | 5152242907 |
Mailing Address: | Po Box 4250, DES MOINES |
State: | IA |
Postal Code: | 503334250 |
Phone Number: | 5152432057 |
Fax Number: | 5152445570 |
NPI Enumeration Date: | 12/28/2010 |
NPI Last Update Date: | 01/06/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 03688 |
Healthcare Provider Taxonomy: (Secondary) | Y |
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 |