Provider Demographics
NPI:1902004260
Name:SEARLES REIERSON, EDITH ANNE (PT)
Entity Type:Individual
Prefix:
First Name:EDITH
Middle Name:ANNE
Last Name:SEARLES REIERSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12125 APPLE RD
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IA
Mailing Address - Zip Code:52141-8017
Mailing Address - Country:US
Mailing Address - Phone:563-423-5197
Mailing Address - Fax:
Practice Address - Street 1:12125 APPLE RD
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IA
Practice Address - Zip Code:52141-8017
Practice Address - Country:US
Practice Address - Phone:563-423-5197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01906225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist