Provider Demographics
NPI:1528442563
Name:BRAATEN HEALTH LLC DBA MIDWEST THERAPY CENTER
Entity type:Organization
Organization Name:BRAATEN HEALTH LLC DBA MIDWEST THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:WITT
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:563-326-1400
Mailing Address - Street 1:3740 UTICA RIDGE RD # 4
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-2478
Mailing Address - Country:US
Mailing Address - Phone:563-326-1400
Mailing Address - Fax:563-326-0700
Practice Address - Street 1:3740 UTICA RIDGE RD # 4
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-2478
Practice Address - Country:US
Practice Address - Phone:563-326-1400
Practice Address - Fax:563-326-0700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-18
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA078352235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty