Healthcare Provider Details

I. General information

NPI: 1437225000
Provider Name (Legal Business Name): PREMIER THERAPY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 10/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 S SADDLE CREEK RD
OMAHA NE
68106-2402
US

IV. Provider business mailing address

1313 S SADDLE CREEK RD
OMAHA NE
68106-2402
US

V. Phone/Fax

Practice location:
  • Phone: 402-933-0100
  • Fax: 402-933-0200
Mailing address:
  • Phone: 402-933-0100
  • Fax: 402-933-0200

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: DR. JENNIFER L BERAN
Title or Position: CO-OWNER
Credential: PT
Phone: 402-933-0100