Healthcare Provider Details

I. General information

NPI: 1144065384
Provider Name (Legal Business Name): ATHENA RACHELLE MENESES DPT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2024
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 N 7TH ST
PLATTSMOUTH NE
68048-1310
US

IV. Provider business mailing address

413 N 7TH ST
PLATTSMOUTH NE
68048-1313
US

V. Phone/Fax

Practice location:
  • Phone: 402-296-2196
  • Fax: 402-296-2197
Mailing address:
  • Phone: 402-730-6644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number4506
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: