Provider Demographics
NPI:1336276559
Name:CALONDER, ADAM (LPT)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:CALONDER
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:TIPTON
Mailing Address - State:IA
Mailing Address - Zip Code:52772-9263
Mailing Address - Country:US
Mailing Address - Phone:319-321-4462
Mailing Address - Fax:
Practice Address - Street 1:540 FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:TIPTON
Practice Address - State:IA
Practice Address - Zip Code:52772-9263
Practice Address - Country:US
Practice Address - Phone:319-321-4462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
02978225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0665463Medicaid
IA0665463Medicaid