Provider Demographics
NPI:1982991998
Name:ROWEDDER, CHRISTOPER L (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPER
Middle Name:L
Last Name:ROWEDDER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5627 NW 86TH ST
Mailing Address - Street 2:# 200
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-1738
Mailing Address - Country:US
Mailing Address - Phone:515-643-9109
Mailing Address - Fax:515-643-9138
Practice Address - Street 1:307 E. SCENIC VALLEY AVENUE
Practice Address - Street 2:SUITE 300
Practice Address - City:INDIANOLA
Practice Address - State:IA
Practice Address - Zip Code:50125-4865
Practice Address - Country:US
Practice Address - Phone:515-643-9109
Practice Address - Fax:515-643-9138
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA4785225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist