Provider Demographics
NPI:1972333599
Name:ROUNDS, TEAL MARIE (PTA)
Entity type:Individual
Prefix:
First Name:TEAL
Middle Name:MARIE
Last Name:ROUNDS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:TEAL
Other - Middle Name:
Other - Last Name:HADENFELDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:810 17TH ST SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-1748
Mailing Address - Country:US
Mailing Address - Phone:319-551-1484
Mailing Address - Fax:
Practice Address - Street 1:2450 HICKORY TRL
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-3579
Practice Address - Country:US
Practice Address - Phone:515-523-4916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA125304225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant