Provider Demographics
NPI:1891127148
Name:RIVERWALK HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:RIVERWALK HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:DITTMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-594-9402
Mailing Address - Street 1:PO BOX 327
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:IA
Mailing Address - Zip Code:52728-0327
Mailing Address - Country:US
Mailing Address - Phone:563-594-9402
Mailing Address - Fax:563-265-8884
Practice Address - Street 1:1134 FRONT ST
Practice Address - Street 2:SUITE 400
Practice Address - City:BUFFALO
Practice Address - State:IA
Practice Address - Zip Code:52728-0327
Practice Address - Country:US
Practice Address - Phone:563-594-9402
Practice Address - Fax:563-265-8884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy