Deanna L Axtell, PTA

Individual provider Active NPI Physical Therapy Assistant · Davenport, IA

NPI 1730516485 · NPPES record last updated Sep 26, 2013

Key facts

NPI
1730516485
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
01017 (IA)
Practice address
700 Waverly Rd
Davenport, IA 52804-4317
Phone
(563) 324-1651
NPI assigned
Sep 26, 2013
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
01017IAMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 01017 IA Yes

Addresses

Primary practice location

700 Waverly Rd
Davenport, IA 52804-4317

Mailing address

700 Waverly Rd
Davenport, IA 52804-4317
Phone (563) 324-1651

Other providers in Davenport, IA

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

Sources for this page

Verify at the official NPI Registry.