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General NPI Number Information
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NPI Number | 1780013490
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Entity Type | Individual
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Provider Name | JADA EXSTROM PT
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Gender | Female
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Dates
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Enumeration Date | 11/03/2013
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Last Update Date | 01/06/2014
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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 | 68506-5240
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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 | 6170 FRANCISCAN DR
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City | LINCOLN
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State | NE
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Zip | 68526-6006
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Country | US
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Telephone | 402-430-3655
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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 | 9854
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3148
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License Number State | NE
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