Healthcare Provider Details
I. General information
NPI: 1700931771
Provider Name (Legal Business Name): J & WHIT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/23/2007
Last Update Date: 06/20/2022
Certification Date: 06/20/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6825 S 27TH ST STE 103
LINCOLN NE
68512-4872
US
IV. Provider business mailing address
3800 W SPRINGVIEW RD
LINCOLN NE
68522-8746
US
V. Phone/Fax
- Phone: 402-420-0020
- Fax: 402-420-0014
- Phone: 402-202-6671
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | 2438 |
| License Number State | NE |
VIII. Authorized Official
Name:
KARI
ANN
JORGENSEN
Title or Position: PHYSICAL THERAPIST
Credential: P.T.
Phone: 402-202-6671