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NPI Code Detail

MEDICARE: VALERIE NICOLE COMBS PTA

MEDICARE: VALERIE NICOLE COMBS PTA
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
1225200000XPhysical Therapy Assistant987NE

General Provider Information

NPI Number : 1568740140
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALERIE NICOLE COMBS PTA
Provider Business Mailing Address
First Line : 7319 N 111TH AVE
Second Line :
City : OMAHA
State : NE
Zip : 68142-1545
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12856 DEAUVILLE DR
Second Line :
City : OMAHA
State : NE
Zip : 68137-3204
Country : US
Telephone Number : 402-895-2266
Fax Number : 402-895-2840
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2011
Last Update Date : 07/29/2011

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Directions to “ VALERIE NICOLE COMBS PTA” Practice Location

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