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Contact Information

GREAT LAKES PHYSICAL THERAPY, PC
3301 BERGQUIST AVE
SPIRIT LAKE, IA51360-7268
 Phone: 712-336-2722
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapy

261QP2000X
 

Rehabilitation

261QR0400X B4[14] Rehabilitation Agency
 

Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)

261QR0401X B4[14] Comprehensive Outpatient Rehabilitation Facility
Indicates primary specialty

NPI Profile & details for GREAT LAKES PHYSICAL THERAPY, PC

NPI Number 1255646709
LBN Legal business name GREAT LAKES PHYSICAL THERAPY, PC
Authorized official DAVID HALLAND - (PHYSICAL THERAPIST)
Entity Organization
Organization subpart 1 No
Enumeration date 08/09/2010
Last updated 08/09/2010 - About 16 years ago
Identifiers
IA License # 00807
IA License # 00868
IA License # 01261
IA License # 01681
IA License # 01929
IA License # 03253
IA License # 055168
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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