Provider Demographics
NPI:1093432221
Name:RESILIENCE PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:RESILIENCE PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CODY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKUP
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:515-401-2086
Mailing Address - Street 1:4497 88TH ST
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-1436
Mailing Address - Country:US
Mailing Address - Phone:515-401-2086
Mailing Address - Fax:
Practice Address - Street 1:8033 UNIVERSITY BLVD STE D
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-1170
Practice Address - Country:US
Practice Address - Phone:515-612-8700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty