Healthcare Provider Details

I. General information

NPI: 1760372122
Provider Name (Legal Business Name): CROFTON PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W MAIN ST.
CROFTON NE
68730
US

IV. Provider business mailing address

PO BOX 55
CROFTON NE
68730-0055
US

V. Phone/Fax

Practice location:
  • Phone: 402-358-0806
  • Fax:
Mailing address:
  • Phone: 402-358-0806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMBER JANSEN
Title or Position: OWNER
Credential: PT
Phone: 402-358-0806