STADIA SPORTS MEDICINE PC NPI 1962453274

NPI Information

STADIA SPORTS MEDICINE PC is a neuromusculoskeletal medicine sports medicine in West Des Moines, IA. The provider is definition to come. STADIA SPORTS MEDICINE PC NPI is 1962453274. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

6000 UNIVERSITY AVE
SUITE 250
WEST DES MOINES, IA
ZIP 50266-203
Phone: (515) 221-1102
Fax: (515) 221-1272

The provider's authorized official is Chad Thomas Carlson .
The authorized official title is Ceo, Stadia Sports Medicine and has the following contact phone number (515) 221-1102.

The CLIA number assigned to this NPI record is 16D1051696 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/12/2006 and was last updated on 8/16/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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