Vicky Carlson

Individual provider Active NPI Physical Therapy Assistant · Onawa, IA

NPI 1396948741 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1396948741
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
585 (IA)
Practice address
222 15TH St
Onawa, IA 51040-1025
Phone
(615) 896-6400
NPI assigned
Jun 5, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
585IAMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 585 IA Yes

Addresses

Primary practice location

222 15TH St
Onawa, IA 51040-1025

Mailing address

3247 Grandview Blvd
Sioux City, IA 51104-2525
Phone (712) 255-3039

Other providers in Onawa, IA

All providers in Onawa, IA · Physical Therapy Assistant in Iowa

Sources for this page

Verify at the official NPI Registry.