Provider Demographics
NPI:1528654399
Name:KIOUS, KACI L (MS, ATC)
Entity type:Individual
Prefix:
First Name:KACI
Middle Name:L
Last Name:KIOUS
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:KACI
Other - Middle Name:L
Other - Last Name:ORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3262 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:LORIMOR
Mailing Address - State:IA
Mailing Address - Zip Code:50149-8054
Mailing Address - Country:US
Mailing Address - Phone:515-313-7498
Mailing Address - Fax:
Practice Address - Street 1:1700 W TOWNLINE ST
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-1054
Practice Address - Country:US
Practice Address - Phone:641-782-7091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002492255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer