Organization Name: | SPORTSPLUS PHYSICAL THERAPY GC LLC |
NPI Number: | 1790140234 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SCOTT CARNAHAN (DIRECTOR) |
Mailing Address: | 606 E 1st St Grundy Center |
State: | IA US |
Postal Code: | 50638 |
Phone Number: | 3198256636 |
Fax Number: | 3198254939 |
NPI Enumeration Date: | 12/29/2015 |
NPI Last Update Date: | 12/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |