Provider Demographics
NPI:1962574640
Name:IOWA PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:IOWA PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MARGHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:319-895-4085
Mailing Address - Street 1:108 1ST ST SE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IA
Mailing Address - Zip Code:52314-1465
Mailing Address - Country:US
Mailing Address - Phone:319-895-4085
Mailing Address - Fax:319-895-8013
Practice Address - Street 1:108 1ST ST SE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IA
Practice Address - Zip Code:52314-1465
Practice Address - Country:US
Practice Address - Phone:319-895-4085
Practice Address - Fax:319-895-8013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0477679Medicaid
IA1285614594OtherNPI
IAI15617Medicare ID - Type UnspecifiedPROVIDER NUMBER
IA1285614594OtherNPI