Provider Demographics
NPI:1720271257
Name:NIGGEMEYER, ERIK THOMAS (PT)
Entity Type:Individual
Prefix:MR
First Name:ERIK
Middle Name:THOMAS
Last Name:NIGGEMEYER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 CENTRAL IOWA DR 70
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158
Mailing Address - Country:US
Mailing Address - Phone:641-754-6120
Mailing Address - Fax:641-754-5019
Practice Address - Street 1:55 CENTRAL IOWA DR
Practice Address - Street 2:SUITE 70
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-5983
Practice Address - Country:US
Practice Address - Phone:641-754-6120
Practice Address - Fax:641-754-5019
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03671225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA75-3139242OtherFTIN
IA75-3139242OtherFTIN
IAIB3481Medicare PIN