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NPI Code Detail

MEDICARE: DONETTE L VIS MPT

MEDICARE:   DONETTE L VIS  MPT
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
1225100000XPhysical Therapist1252NE

General Provider Information

NPI Number : 1255533030
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONETTE L VIS MPT
Provider Business Mailing Address
First Line : 3420 34TH ST
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-1420
Country : US
Telephone Number : 402-910-8189
Fax Number :
Provider Business Practice Location Address
First Line : 3005 19TH ST STE 600
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-4248
Country : US
Telephone Number : 402-562-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2007
Last Update Date : 11/13/2020

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Directions to “ DONETTE L VIS MPT” Practice Location

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