Provider Demographics
NPI:1598983835
Name:PHYSIOTHERAPY ASSOCIATES
Entity Type:Organization
Organization Name:PHYSIOTHERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GROUP BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALYCIA
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:ANDREASEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-398-1569
Mailing Address - Street 1:4700 TAMA ST SE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-4556
Mailing Address - Country:US
Mailing Address - Phone:319-447-0700
Mailing Address - Fax:
Practice Address - Street 1:600 7TH ST SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401-2112
Practice Address - Country:US
Practice Address - Phone:319-398-1569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0665430Medicaid
IA0665430Medicaid