MEDICARE: JOSHUA JOSEPH FITCHNER DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2982	NE

General Provider Information

NPI Number	:	1003100801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA JOSEPH FITCHNER DPT

Provider Business Mailing Address
First Line	:	2307 OSBORNE DR W
Second Line	:
City	:	HASTINGS
State	:	NE
Zip	:	68901-9116
Country	:	US
Telephone Number	:	402-462-2665
Fax Number	:	402-462-2668

Provider Business Practice Location Address
First Line	:	2307 OSBORNE DR W
Second Line	:
City	:	HASTINGS
State	:	NE
Zip	:	68901-9116
Country	:	US
Telephone Number	:	402-462-2665
Fax Number	:	402-462-2668

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2011
Last Update Date	:	06/09/2011

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