Healthcare Provider Details

I. General information

NPI: 1366544231
Provider Name (Legal Business Name): ALPHA REHABILITATION, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 06/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 E 56TH ST BLDG A
KEARNEY NE
68847-8628
US

IV. Provider business mailing address

920 E 56TH ST BLDG A
KEARNEY NE
68847-8628
US

V. Phone/Fax

Practice location:
  • Phone: 308-233-5060
  • Fax: 308-233-5062
Mailing address:
  • Phone: 308-233-5060
  • Fax: 308-233-5062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JESSICA R THOENE
Title or Position: SLP/OWNER
Credential:
Phone: 308-233-5060