NPI 1457778870

Concentra

Organisation PACE Provider Organization Davenport, IA

Practice location

Address: 3540 E 46th St, Davenport, IA 52807
Phone: (563) 359-1170
Mailing address: 3540 E 46th Street, Davenport, IA 52807

Authorised official

Name: Tammy Renee Whitacre
Title: Physical Therapist Assistant
Phone: (563) 571-1104

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X Licence 01242 (IA)

Other Program of All-Inclusive Care for the Elderly (PACE) Provider Organization providers in Iowa →

Registry record

NPI: 1457778870
Entity type: Organization
NPI issued: 24 Mar 2014
Record last updated: 24 Mar 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.