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General NPI Number Information
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NPI Number | 1487940698
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Entity Type | Organization
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Legal Business Name | VALENTINE PHYSICAL THERAPY AND SPORTS REHAB, LLC.
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Dates
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Enumeration Date | 06/26/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 130 W 4TH ST
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City | VALENTINE
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State | NE
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Zip | 69201-1830
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Country | US
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Telephone | 402-376-1140
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Fax | 402-376-1140
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Provider Business Mailing Address
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Address Line | 130 W 4TH ST
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City | VALENTINE
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State | NE
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Zip | 69201-1830
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Country | US
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Telephone | 402-376-1140
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Fax | 402-376-1140
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | LANELL MAE GRAHAM
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Credential | D.P.T.
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Telephone | 402-340-6501
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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 | 2861
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License Number State | NE
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