Healthcare Provider Details

I. General information

NPI: 1497076756
Provider Name (Legal Business Name): DANIEL JAMES WITTE DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 02/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1268 E HENRY STREET SUITE 1
LOUISVILLE NE
68037
US

IV. Provider business mailing address

PO BOX 68
LOUISVILLE NE
68037-0068
US

V. Phone/Fax

Practice location:
  • Phone: 402-234-3333
  • Fax: 844-272-6479
Mailing address:
  • Phone: 402-234-3333
  • Fax: 402-234-3333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2866
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: