Provider Demographics
NPI:1215106661
Name:ONEOTA PHYSICAL THERAPY INC.
Entity type:Organization
Organization Name:ONEOTA PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:FECHNER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:563-382-1289
Mailing Address - Street 1:308 COLLEGE DR STE 4
Mailing Address - Street 2:
Mailing Address - City:DECORAH
Mailing Address - State:IA
Mailing Address - Zip Code:52101-1342
Mailing Address - Country:US
Mailing Address - Phone:563-382-1289
Mailing Address - Fax:563-382-4824
Practice Address - Street 1:308 COLLEGE DR STE 4
Practice Address - Street 2:
Practice Address - City:DECORAH
Practice Address - State:IA
Practice Address - Zip Code:52101-1342
Practice Address - Country:US
Practice Address - Phone:563-382-1289
Practice Address - Fax:563-382-4824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03817261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy