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General NPI Number Information
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NPI Number | 1013576818
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Entity Type | Individual
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Provider Name | TRACY NICOLE CYBORON PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 06/06/2019
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Provider Practice Location Address
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Address Line | 3200 RAASCH DR
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City | NORFOLK
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State | NE
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Zip | 68701-3455
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Country | US
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Telephone | 402-371-2722
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Fax |
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Provider Business Mailing Address
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Address Line | 1314 AVENUE F
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City | WISNER
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State | NE
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Zip | 68791
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Country | US
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Telephone | 308-216-1204
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3941
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License Number State | NE
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