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General NPI Number Information
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NPI Number | 1770482135
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Entity Type | Organization
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Legal Business Name | FPGYM PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 11/03/2026
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Last Update Date | 11/03/2026
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Provider Practice Location Address
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Address Line | 2275 S 132ND ST
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City | OMAHA
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State | NE
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Zip | 68144-2501
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Country | US
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Telephone | 855-749-7461
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Fax |
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Provider Business Mailing Address
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Address Line | 6100 E CENTRAL AVE STE 3
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City | WICHITA
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State | KS
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Zip | 67208-4237
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CCO
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Name | BRIAN HERSHBERGER
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Credential | PT, MPT
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Telephone | 301-787-0989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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