Provider Demographics
NPI:1306259460
Name:FIVE SEASONS PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:FIVE SEASONS PHYSICAL THERAPY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:D
Authorized Official - Last Name:NEIGHBOR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:319-294-6694
Mailing Address - Street 1:740 N 15TH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233-2384
Mailing Address - Country:US
Mailing Address - Phone:319-294-6694
Mailing Address - Fax:319-294-6113
Practice Address - Street 1:740 N 15TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-2384
Practice Address - Country:US
Practice Address - Phone:319-294-6694
Practice Address - Fax:319-294-6113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-06
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy