Basic Information
| Provider Information | |||||||||
| NPI: | 1699157925 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAY | ||||||||
| FirstName: | MICHAEL | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1111 11TH ST | ||||||||
| Address2: | |||||||||
| City: | HAWARDEN | ||||||||
| State: | IA | ||||||||
| PostalCode: | 510231903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7125513108 | ||||||||
| FaxNumber: | 7125513177 | ||||||||
| Practice Location | |||||||||
| Address1: | 1111 11TH ST | ||||||||
| Address2: | |||||||||
| City: | HAWARDEN | ||||||||
| State: | IA | ||||||||
| PostalCode: | 510231903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7125513108 | ||||||||
| FaxNumber: | 7125513177 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2015 | ||||||||
| LastUpdateDate: | 06/30/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 02000 | IA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 0691 | SD | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.