Healthcare Provider Details

I. General information

NPI: 1699691386
Provider Name (Legal Business Name): COLLEEN MCLAUGHLIN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13609 CALIFORNIA ST
OMAHA NE
68154-5260
US

IV. Provider business mailing address

1810 E CUMBERLAND BLVD
WHITEFISH BAY WI
53211-1229
US

V. Phone/Fax

Practice location:
  • Phone: 800-259-9897
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17711-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: