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General NPI Number Information
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NPI Number | 1881226926
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Entity Type | Individual
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Provider Name | PAYTON M DOSTAL OT
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Gender | Female
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Dates
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Enumeration Date | 02/06/2020
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 6101 VILLAGE DR STE 100
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City | LINCOLN
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State | NE
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Zip | 68516-5830
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Country | US
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Telephone | 402-420-2626
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Fax |
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Provider Business Mailing Address
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Address Line | 1651 N 86TH ST STE 100
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City | LINCOLN
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State | NE
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Zip | 68505-3719
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Country | US
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Telephone | 402-484-7117
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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