Healthcare Provider Details

I. General information

NPI: 1689317380
Provider Name (Legal Business Name): COLEMAN WESTERBY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 MOHAVE DR STE A
LINCOLN NE
68516-9456
US

IV. Provider business mailing address

8500 MOHAVE DR STE A
LINCOLN NE
68516-9456
US

V. Phone/Fax

Practice location:
  • Phone: 402-486-0602
  • Fax: 402-486-0604
Mailing address:
  • Phone: 308-850-3871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: