| Blake Tiedtke, DPT | |
|
645 32nd Ave Sw, Ste A, Cedar Rapids, IA 52404-3907 | |
| (319) 363-2901 | |
| (319) 363-2903 |
| Full Name | Blake Tiedtke |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Experience | 17 Years |
| Location | 645 32nd Ave Sw, Cedar Rapids, Iowa |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922248566 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | 004341 (Iowa) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Match Play Tennis Centers Inc | 0042262008 | 11 |
| Entity Name | Match Play Tennis Centers Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760540926 PECOS PAC ID: 0042262008 Enrollment ID: O20050217000697 |
| Mailing Address | Practice Location Address |
|---|---|
| Blake Tiedtke, DPT 3290 Ridgeway Dr, Ste 3, Coralville, IA 52241 Ph: (319) 665-2630 | Blake Tiedtke, DPT 645 32nd Ave Sw, Ste A, Cedar Rapids, IA 52404-3907 Ph: (319) 363-2901 |
Alexander Gaffney, Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 218 4th Ave Sw, Cedar Rapids, IA 52404 Phone: 319-200-6102 | |
Mr. Devin Robert Hilar Smith, M.D. Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 1026 A Ave Ne, Cedar Rapids, IA 52402 Phone: 319-369-7331 Fax: 319-369-8251 | |
Kyle Bernard, PT Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 645 32nd Ave Sw, Cedar Rapids, IA 52404 Phone: 319-363-2901 Fax: 319-363-2903 | |
Nicholas R Appleby, D.O. Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 1026 A Ave Ne, Cedar Rapids, IA 52402 Phone: 319-369-7211 | |
Dr. Roman Magid, DO Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 855 A Ave Ne Ste 105, Cedar Rapids, IA 52402 Phone: 319-368-5992 | |
Aaron Sloterdyk, DPT Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 645 32nd Ave Sw Ste A, Cedar Rapids, IA 52404 Phone: 319-363-2901 Fax: 319-363-2903 | |
Craig A Dove, D.O. Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 1026 A Ave Ne, Cedar Rapids, IA 52402 Phone: 319-369-7331 Fax: 319-369-8251 |