Provider Demographics
NPI:1801806419
Name:ROONEY, JERRY LEONARD (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:JERRY
Middle Name:LEONARD
Last Name:ROONEY
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1111 E MARION ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50138-1835
Mailing Address - Country:US
Mailing Address - Phone:641-842-6612
Mailing Address - Fax:
Practice Address - Street 1:1002 S LINCOLN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:IA
Practice Address - Zip Code:50138-3155
Practice Address - Country:US
Practice Address - Phone:641-842-2151
Practice Address - Fax:641-842-1481
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00155225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist