Basic Information
| Provider Information | |||||||||
| NPI: | 1801806419 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROONEY | ||||||||
| FirstName: | JERRY | ||||||||
| MiddleName: | LEONARD | ||||||||
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| Credential: | PHYSICAL THERAPIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1111 E MARION ST | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 501381835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6418426612 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1002 S LINCOLN | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 501383155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6418422151 | ||||||||
| FaxNumber: | 6418421481 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2006 | ||||||||
| LastUpdateDate: | 02/24/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 00155 | IA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.