National Provider Identifier Database

STADIA SPORTS MEDICINE PC
Neuromusculoskeletal Medicine, Sports Medicine

A Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician trained to be responsible for the continuous care in the field of sports medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine and integrates each of these into the management of the individual engaged in physical exercise (sports) whether as an individual or in team participation.


Contact Information

STADIA SPORTS MEDICINE PC
6000 UNIVERSITY AVE
SUITE 250
WEST DES MOINES, IA50266-8203
Phone: 515-221-1102
Fax: 515-221-1272
Website:
Specialty Taxonomy Code
* Neuromusculoskeletal Medicine, Sports Medicine 204C00000X
Physical Therapist 225100000X

* Indicates primary specialty

NPI Profile & details for STADIA SPORTS MEDICINE PC

NPI Number 1962453274
Legal business name
LBN
STADIA SPORTS MEDICINE PC
Authorized official CHAD CARLSON - (CEO, STADIA SPORTS MEDICINE)
Entity Organization
Organization subpart No
Enumeration date 05/12/2006
Last updated 08/16/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • IA License #: 36501

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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