Healthcare Provider Details

I. General information

NPI: 1205442076
Provider Name (Legal Business Name): ENCOMPASS PHYSICAL THERAPY AND FITNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2020
Last Update Date: 10/22/2020
Certification Date: 10/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 10TH AVE
SIDNEY NE
69162-2060
US

IV. Provider business mailing address

1340 10TH AVE
SIDNEY NE
69162-2060
US

V. Phone/Fax

Practice location:
  • Phone: 308-254-2225
  • Fax: 308-254-5000
Mailing address:
  • Phone: 308-254-2225
  • Fax: 308-254-5000

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: ROBYN HICKS
Title or Position: PT/OWNER
Credential:
Phone: 308-250-2892