Provider Demographics
NPI:1568465789
Name:JOHN T. VOYLES AND OR HEATHER K. VOYLES
Entity Type:Organization
Organization Name:JOHN T. VOYLES AND OR HEATHER K. VOYLES
Other - Org Name:SOUTH EAST IOWA PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND P.T.
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:VOYLES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:641-682-8171
Mailing Address - Street 1:SOUTH EAST IOWA PHYSICAL THERAPY
Mailing Address - Street 2:115 S WASHINGTON ST
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-2531
Mailing Address - Country:US
Mailing Address - Phone:641-682-8171
Mailing Address - Fax:641-682-9054
Practice Address - Street 1:SOUTH EAST IOWA PHYSICAL THERAPY
Practice Address - Street 2:115 S WASHINGTON ST
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2531
Practice Address - Country:US
Practice Address - Phone:641-682-8171
Practice Address - Fax:641-682-9054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02109225100000X
IA02520225100000X
IA02125225100000X
IA02941225100000X
IA04012225100000X
IA078601225100000X
IA00279225200000X
IA00376225200000X
IA001368225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0665349Medicaid
IA6-6534OtherBCBS GROUP PROVIDER NUMBE
IA6-6534OtherBCBS GROUP PROVIDER NUMBE
IA=========OtherJOHN DEERE HEALTH -UHC