Provider Demographics
NPI:1689052250
Name:VERSCHOOR, JOSEPH (DPT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:VERSCHOOR
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:STORM LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50588-1743
Mailing Address - Country:US
Mailing Address - Phone:712-732-7724
Mailing Address - Fax:712-732-1275
Practice Address - Street 1:HIGHWAY 71 SOUTH
Practice Address - Street 2:BOX AB
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360-0159
Practice Address - Country:US
Practice Address - Phone:712-336-8651
Practice Address - Fax:712-336-8641
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA005212225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist