Provider Demographics
NPI:1972041549
Name:GERBER, JARED
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:GERBER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 E 3RD ST N
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:IA
Mailing Address - Zip Code:50208-3210
Mailing Address - Country:US
Mailing Address - Phone:641-791-9675
Mailing Address - Fax:641-787-9006
Practice Address - Street 1:321 E 3RD ST N
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:IA
Practice Address - Zip Code:50208-3210
Practice Address - Country:US
Practice Address - Phone:641-791-9675
Practice Address - Fax:641-787-9006
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA085264225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist