Healthcare Provider Details

I. General information

NPI: 1376623298
Provider Name (Legal Business Name): MILFORD PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 11/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 1ST ST
MILFORD NE
68405-9701
US

IV. Provider business mailing address

511 FIRST ST PO BOX 747
MILFORD NE
68405
US

V. Phone/Fax

Practice location:
  • Phone: 402-761-4000
  • Fax: 402-761-4005
Mailing address:
  • Phone: 402-761-4000
  • Fax: 402-761-4005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: BRETT I SMITH
Title or Position: OWNER
Credential:
Phone: 402-761-4000