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General NPI Number Information
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NPI Number | 1588132799
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Entity Type | Individual
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Provider Name | SAMANTHA JANE HERBSTER DPT
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Gender | Female
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Dates
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Enumeration Date | 11/06/2018
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Last Update Date | 11/06/2018
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Provider Practice Location Address
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Address Line | 10824 OLD MILL RD STE 10-6
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City | OMAHA
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State | NE
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Zip | 68154-2642
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Country | US
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Telephone | 531-333-2613
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Fax |
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Provider Business Mailing Address
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Address Line | 8811 WEBSTER PLZ
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City | OMAHA
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State | NE
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Zip | 68114-2832
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Country | US
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Telephone | 531-333-2613
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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 | 3636
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License Number State | NE
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