Blake Coughenour
Physical Therapist in Waukee, IA. Individual provider (NPI-1).
NPI number1124874375
StatusActive
Last updated in NPPESMay 28, 2024
Details
- NPI
- 1124874375
- Entity type
- Individual (NPI-1)
- Name
- Blake Coughenour
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 29, 2024
- Certification date
- May 28, 2024
- Last updated
- May 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 124144 | IA | Yes |
Practice location
128 W Hickman RdWaukee, IA 50263-5070
Phone 515-309-1819
Mailing address
2122 York Rd Ste 300Oak Brook, IL 60523-1925
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All 44 Physical Therapist providers in Waukee · All 429 providers in Waukee
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