Provider Demographics
NPI:1255698957
Name:CENTER FOR OCCUPATIONAL AND PHYSICAL MEDICINE
Entity type:Organization
Organization Name:CENTER FOR OCCUPATIONAL AND PHYSICAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TOCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFLEUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-457-3000
Mailing Address - Street 1:13375 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8261
Mailing Address - Country:US
Mailing Address - Phone:515-457-3000
Mailing Address - Fax:515-457-3002
Practice Address - Street 1:13375 UNIVERSITY AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8261
Practice Address - Country:US
Practice Address - Phone:515-457-3000
Practice Address - Fax:515-457-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-19
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine