Provider Demographics
NPI:1831502319
Name:IOWA CITY PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:IOWA CITY PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:D
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:319-339-4278
Mailing Address - Street 1:2220 MORMON TREK BLVD
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-4435
Mailing Address - Country:US
Mailing Address - Phone:319-339-4278
Mailing Address - Fax:319-339-9808
Practice Address - Street 1:2220 MORMON TREK BLVD
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-4435
Practice Address - Country:US
Practice Address - Phone:319-339-4278
Practice Address - Fax:319-339-9808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy