Healthcare Provider Details

I. General information

NPI: 1700798717
Provider Name (Legal Business Name): GROW PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 W PHILLIP AVE
NORFOLK NE
68701-5208
US

IV. Provider business mailing address

512 W PHILLIP AVE
NORFOLK NE
68701-5208
US

V. Phone/Fax

Practice location:
  • Phone: 402-644-2500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JESSIE KORTH
Title or Position: MANAGING MEMBER
Credential: PT, DPT
Phone: 402-841-5377