Provider Demographics
NPI:1770915753
Name:MAXFIELD, ABBIE MARIE (PTA, LMT)
Entity type:Individual
Prefix:
First Name:ABBIE
Middle Name:MARIE
Last Name:MAXFIELD
Suffix:
Gender:F
Credentials:PTA, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 HIGHWAY 1 W
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-4204
Mailing Address - Country:US
Mailing Address - Phone:319-354-3824
Mailing Address - Fax:319-354-3826
Practice Address - Street 1:434 HIGHWAY 1 W
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-4204
Practice Address - Country:US
Practice Address - Phone:319-354-3824
Practice Address - Fax:319-354-3826
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA005077225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant