Provider Demographics
NPI:1932152733
Name:HARRINGTON, RAYMOND JOSEPH (PT)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:JOSEPH
Last Name:HARRINGTON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:RAY
Other - Middle Name:JOSEPH
Other - Last Name:HARRINGTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 2758
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50704-2758
Mailing Address - Country:US
Mailing Address - Phone:319-833-5900
Mailing Address - Fax:319-833-5901
Practice Address - Street 1:1631 LOGAN AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-1237
Practice Address - Country:US
Practice Address - Phone:319-232-2630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01153225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA42141730747OtherJOHN DEERE HEALTH INS PLA
IA3230920Medicaid
IA51912OtherWELLMARK INS PLAN
IA3230920Medicaid