Healthcare Provider Details

I. General information

NPI: 1174982243
Provider Name (Legal Business Name): KIMBERLY SCHULTZ DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2016
Last Update Date: 02/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4920 N 26TH ST SUITE 100
LINCOLN NE
68521-4748
US

IV. Provider business mailing address

4920 N 26TH ST SUITE 100
LINCOLN NE
68521-4748
US

V. Phone/Fax

Practice location:
  • Phone: 402-434-5361
  • Fax: 402-434-5365
Mailing address:
  • Phone: 402-434-5361
  • Fax: 402-434-5365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number3402
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: