Provider Demographics
NPI:1073820684
Name:CENTRAL IOWA THERAPIES
Entity Type:Organization
Organization Name:CENTRAL IOWA THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:HEATH
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:515-352-3228
Mailing Address - Street 1:2213 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-5305
Mailing Address - Country:US
Mailing Address - Phone:515-237-3974
Mailing Address - Fax:515-883-2692
Practice Address - Street 1:1107 MARKET STREET
Practice Address - Street 2:
Practice Address - City:GOWRIE
Practice Address - State:IA
Practice Address - Zip Code:50543-7714
Practice Address - Country:US
Practice Address - Phone:515-352-3228
Practice Address - Fax:515-352-3229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004202225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty