Healthcare Provider Details

I. General information

NPI: 1851741870
Provider Name (Legal Business Name): CASEY WEISS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2016
Last Update Date: 06/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6825 S 27TH ST SUITE 103
LINCOLN NE
68512-4872
US

IV. Provider business mailing address

6825 S 27TH ST SUITE 103
LINCOLN NE
68512-4872
US

V. Phone/Fax

Practice location:
  • Phone: 402-420-0020
  • Fax: 402-420-0014
Mailing address:
  • Phone: 402-420-0020
  • Fax: 402-420-0014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3597
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: