Provider Demographics
NPI:1174744452
Name:ERNST, ADELHEID CHRISTINE (PT)
Entity type:Individual
Prefix:MRS
First Name:ADELHEID
Middle Name:CHRISTINE
Last Name:ERNST
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1936 TAYLOR AVE
Mailing Address - Street 2:P.O.BOX 894
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-9598
Mailing Address - Country:US
Mailing Address - Phone:641-752-6863
Mailing Address - Fax:
Practice Address - Street 1:1307 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:IA
Practice Address - Zip Code:52342-2307
Practice Address - Country:US
Practice Address - Phone:641-484-5253
Practice Address - Fax:641-484-5312
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01486225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist