Provider Demographics
NPI:1962081091
Name:PROPRIOCEPTION INC
Entity type:Organization
Organization Name:PROPRIOCEPTION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDEN WYNBOOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-289-4549
Mailing Address - Street 1:2675 N ANKENY BLVD STE 113
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-4719
Mailing Address - Country:US
Mailing Address - Phone:515-289-4549
Mailing Address - Fax:
Practice Address - Street 1:2675 N ANKENY BLVD STE 113
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4719
Practice Address - Country:US
Practice Address - Phone:515-289-4549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-06
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy