Healthcare Provider Details

I. General information

NPI: 1477712032
Provider Name (Legal Business Name): MATTHEW L SCHWAGER D.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2008
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 S CODDINGTON AVE STE C
LINCOLN NE
68522-4402
US

IV. Provider business mailing address

1550 S CODDINGTON AVE STE C
LINCOLN NE
68522-4402
US

V. Phone/Fax

Practice location:
  • Phone: 402-423-0303
  • Fax: 402-423-0202
Mailing address:
  • Phone: 402-423-0303
  • Fax: 402-423-0202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2643
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2643
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: