Healthcare Provider Details

I. General information

NPI: 1053224261
Provider Name (Legal Business Name): EMPOWERED MOBILITY PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17316 WOOLWORTH AVE
OMAHA NE
68130-1130
US

IV. Provider business mailing address

17316 WOOLWORTH AVE
OMAHA NE
68130-1130
US

V. Phone/Fax

Practice location:
  • Phone: 605-360-4964
  • Fax:
Mailing address:
  • Phone: 605-360-4964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DREW BURGGRAFF
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 605-360-4964