Healthcare Provider Details

I. General information

NPI: 1730285180
Provider Name (Legal Business Name): PHYSICAL THERAPY & SPORTS REHAB OF HASTINGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 S BURLINGTON AVE
HASTINGS NE
68901-5905
US

IV. Provider business mailing address

207 S BURLINGTON AVE
HASTINGS NE
68901-5905
US

V. Phone/Fax

Practice location:
  • Phone: 402-462-8824
  • Fax: 402-462-8017
Mailing address:
  • Phone: 402-462-8824
  • Fax: 402-462-8017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: REBECCA J RAITT
Title or Position: OFFICE MANAGER
Credential:
Phone: 402-462-8824