David Edwin Wiley, PT
Individual provider Active NPI Physical Therapist · Lansing, IA
NPI 1295059244 · NPPES record last updated Mar 19, 2010
Key facts
- NPI
- 1295059244
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 4399-24 (WI)
- Practice address
- 1656 Village Creek Dr
Lansing, IA 52151-7571 - Phone
- (608) 386-0372
- NPI assigned
- Mar 19, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4399-24 | WI | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4399-24 | WI | Yes |
Addresses
Primary practice location
1656 Village Creek Dr
Lansing, IA 52151-7571
Mailing address
PO Box 553
Lansing, IA 52151-0553
Phone (608) 386-0372
Other providers in Lansing, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.