Healthcare Provider Details

I. General information

NPI: 1417323353
Provider Name (Legal Business Name): KATHERINE ELAINE KOGLER KUGLER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2015
Last Update Date: 09/16/2021
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17055 FRANCES ST STE 100
OMAHA NE
68130-4655
US

IV. Provider business mailing address

2500 CALIFORNIA PLZ STE 123A
OMAHA NE
68178-0128
US

V. Phone/Fax

Practice location:
  • Phone: 402-280-3555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3506
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: