Healthcare Provider Details

I. General information

NPI: 1104417567
Provider Name (Legal Business Name): KOBZA PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2021
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11863 S 216TH ST STE 4
GRETNA NE
68028-5406
US

IV. Provider business mailing address

2110 S 186TH ST
OMAHA NE
68130-2773
US

V. Phone/Fax

Practice location:
  • Phone: 402-502-9004
  • Fax: 402-502-9006
Mailing address:
  • Phone: 402-680-1617
  • Fax: 402-502-9006

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: DR. AARON MICHAEL KOBZA
Title or Position: OWNER
Credential: DPT
Phone: 402-680-1617