Jeremy Mozak
Individual provider Active NPI Physical Therapy Assistant · Sergeant Bluff, IA
NPI 1861820060 · NPPES record last updated Oct 24, 2013
Key facts
- NPI
- 1861820060
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 001415 (IA)
- Practice address
- 206 Port Neal Rd
Sergeant Bluff, IA 51054-8098 - Phone
- (712) 943-3837
- NPI assigned
- Oct 24, 2013
- Sex
- Male
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 001415 | IA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 001415 | IA | Yes |
Addresses
Primary practice location
206 Port Neal Rd
Sergeant Bluff, IA 51054-8098
Mailing address
206 Port Neal Rd
Sergeant Bluff, IA 51054-8098
Phone (712) 943-3837
Other providers in Sergeant Bluff, IA
- Live Young Medical LLC
- Colt Ludwig
- Audrey Mangulabnan
- Sheri McCluskey
- Mid-Step Services, Inc.
- Linda Kay Nelson
- Nissen Family Chiropractic PC
- Lyle D Nissen
- Grant Michael Nobles
- Oluwatoyin Adebanke Oyerinde
All providers in Sergeant Bluff, IA · Physical Therapy Assistant in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2013. 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.