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General NPI Number Information
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NPI Number | 1881830404
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Entity Type | Organization
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Legal Business Name | MARIAN LORD, PHYSICAL THERAPIST, P.C.
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Dates
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Enumeration Date | 01/02/2009
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Last Update Date | 03/11/2009
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Provider Practice Location Address
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Address Line | 14441 DUPONT CT SUITE 102
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City | OMAHA
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State | NE
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Zip | 68144-2153
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Country | US
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Telephone | 402-334-6213
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Fax | 402-334-6218
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Provider Business Mailing Address
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Address Line | 14441 DUPONT CT SUITE 102
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City | OMAHA
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State | NE
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Zip | 68144-2153
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Country | US
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Telephone | 402-334-6213
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Fax | 402-334-6218
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARIAN JEAN LORD
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Credential | P.T.
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Telephone | 402-334-6213
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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 | 712
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License Number State | NE
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