Michelle Dawn Blackburn
Individual provider Active NPI Physical Therapy Assistant · Hiawatha, IA
NPI 1881434744 · NPPES record last updated May 29, 2024
Key facts
- NPI
- 1881434744
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 005091 (IA)
- Practice address
- 125 E Boyson Rd Apt 606
Hiawatha, IA 52233-1282 - Phone
- (319) 202-4825
- NPI assigned
- May 29, 2024
- Sex
- Female
- 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 |
|---|---|---|---|
| 005091 | IA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 005091 | IA | Yes |
Addresses
Primary practice location
125 E Boyson Rd Apt 606
Hiawatha, IA 52233-1282
Mailing address
125 E Boyson Rd Apt 606
Hiawatha, IA 52233-1282
Other providers in Hiawatha, IA
- Sarah Bell
- Sarah O Bengtson
- Douglas James Berry
- Amanda Besler
- Heidi Lynn Blachley
- Paul Steven Boeke
- John Bolenbaugh
- Christine M Botkin
- Boyson Chiropractic, P.C.
- Boyson Dental Associates PLC
All providers in Hiawatha, 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 May 29, 2024. 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.