Healthcare Provider Details

I. General information

NPI: 1275563645
Provider Name (Legal Business Name): PHYSIOTHERAPY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 02/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5017 LEAVENWORTH ST SUITE 101
OMAHA NE
68106-1438
US

IV. Provider business mailing address

5017 LEAVENWORTH ST SUITE 101
OMAHA NE
68106-1438
US

V. Phone/Fax

Practice location:
  • Phone: 402-553-5332
  • Fax:
Mailing address:
  • Phone: 402-553-5332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DENNIS FITZPATRICK
Title or Position: CFO
Credential:
Phone: 610-644-7824