Provider Demographics
NPI:1366818395
Name:BRAATEN HEALTH LLC DBA MIDWEST THERAPY CENTER
Entity Type:Organization
Organization Name:BRAATEN HEALTH LLC DBA MIDWEST THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WITT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:563-326-1400
Mailing Address - Street 1:1601 EAGLES CREST AVE
Mailing Address - Street 2:APT C9
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-5074
Mailing Address - Country:US
Mailing Address - Phone:563-357-3635
Mailing Address - Fax:
Practice Address - Street 1:3740 UTICA RIDGE RD
Practice Address - Street 2:SUITE 5
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-1657
Practice Address - Country:US
Practice Address - Phone:563-326-1400
Practice Address - Fax:563-326-0700
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRAATEN HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA079070225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty