Provider Demographics
NPI:1548636038
Name:MIDWEST THERAPY CENTER
Entity type:Organization
Organization Name:MIDWEST THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WITT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:563-326-1400
Mailing Address - Street 1:3740 UTICA RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-1657
Mailing Address - Country:US
Mailing Address - Phone:563-326-1400
Mailing Address - Fax:563-326-0700
Practice Address - Street 1:3740 UTICA RIDGE RD
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-1657
Practice Address - Country:US
Practice Address - Phone:563-326-1400
Practice Address - Fax:563-326-0700
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRAATEN HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA078740235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty