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General NPI Number Information
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NPI Number | 1144287897
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Entity Type | Organization
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Legal Business Name | CROSSROADS PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 08/20/2008
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Provider Practice Location Address
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Address Line | 6101 S 56TH ST SUITE # 1
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City | LINCOLN
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State | NE
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Zip | 68516-3392
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Country | US
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Telephone | 402-420-0800
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Fax | 402-420-0801
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Provider Business Mailing Address
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Address Line | 6101 S 56TH ST SUITE # 1
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City | LINCOLN
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State | NE
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Zip | 68516-3392
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Country | US
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Telephone | 402-420-0800
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Fax | 402-420-0801
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Authorized Official
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Title or Position | PHYSICAL THERAPIST OWNER
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Name | CONNIE SUE HORNE
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Credential | MSPT
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Telephone | 402-420-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 018829772
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License Number State | NE
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