Provider Demographics
NPI:1043474224
Name:MCEOWEN, DAVID GERALD (DPT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:GERALD
Last Name:MCEOWEN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 COLLINS RD NE
Mailing Address - Street 2:# 154-100
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52498-0505
Mailing Address - Country:US
Mailing Address - Phone:515-633-7836
Mailing Address - Fax:
Practice Address - Street 1:1220 JACOLYN DR SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-1288
Practice Address - Country:US
Practice Address - Phone:319-936-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004261225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
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