Healthcare Provider Details

I. General information

NPI: 1760415764
Provider Name (Legal Business Name): HRUSKA CLINIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 10/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5241 R ST
LINCOLN NE
68504-3422
US

IV. Provider business mailing address

5241 R ST
LINCOLN NE
68504-3422
US

V. Phone/Fax

Practice location:
  • Phone: 402-467-4545
  • Fax: 402-467-4580
Mailing address:
  • Phone: 402-467-4545
  • Fax: 402-467-4580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RONALD J. HRUSKA JR.
Title or Position: OWNER/PRESIDENT
Credential: PT
Phone: 402-467-4545