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General NPI Number Information
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NPI Number | 1386776078
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Entity Type | Organization
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Legal Business Name | EXSTROM PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 07/03/2012
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Provider Practice Location Address
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Address Line | 3818 NORMAL BLVD
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City | LINCOLN
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State | NE
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Zip | 68506
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Country | US
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Telephone | 402-488-4282
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Fax | 402-488-6157
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Provider Business Mailing Address
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Address Line | 3818 NORMAL BLVD
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City | LINCOLN
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State | NE
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Zip | 68506
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Country | US
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Telephone | 402-488-4282
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Fax | 402-488-6157
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DENISE ANNE EXSTROM LARSEN
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Credential | P.T
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Telephone | 402-488-4282
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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 |
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License Number State |
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