Provider Demographics
NPI:1497961528
Name:MCGONEGLE, GERI LEE (PT)
Entity Type:Individual
Prefix:
First Name:GERI
Middle Name:LEE
Last Name:MCGONEGLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5115 WAKONDA DR
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:IA
Mailing Address - Zip Code:50211-1764
Mailing Address - Country:US
Mailing Address - Phone:515-827-5339
Mailing Address - Fax:515-263-5710
Practice Address - Street 1:1301 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-2350
Practice Address - Country:US
Practice Address - Phone:515-263-5143
Practice Address - Fax:515-263-5710
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA12422251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic