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NPI Code Detail

MEDICARE: DR. NICHOLAS JAMES WEBER PT, DPT

MEDICARE: DR. NICHOLAS JAMES WEBER PT, 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
1225100000XPhysical Therapist3606NE
22251X0800XOrthopedic Physical TherapistPTL.0012676CO

General Provider Information

NPI Number : 1316350838
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICHOLAS JAMES WEBER PT, DPT
Provider Business Mailing Address
First Line : 7818 DODGE ST
Second Line :
City : OMAHA
State : NE
Zip : 68114-3412
Country : US
Telephone Number : 402-493-6808
Fax Number : 402-493-6979
Provider Business Practice Location Address
First Line : 7818 DODGE ST
Second Line :
City : OMAHA
State : NE
Zip : 68114-3412
Country : US
Telephone Number : 402-493-6808
Fax Number : 402-493-6979
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2014
Last Update Date : 04/11/2017

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