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General NPI Number Information
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NPI Number | 1902438385
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Entity Type | Organization
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Legal Business Name | ANDERSON MOBILE THERAPY, LLC
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Dates
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Enumeration Date | 02/04/2020
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Last Update Date | 03/09/2020
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Provider Practice Location Address
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Address Line | 7834 N 153RD ST
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City | BENNINGTON
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State | NE
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Zip | 68007-1565
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Country | US
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Telephone | 402-210-6120
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Fax |
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Provider Business Mailing Address
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Address Line | 7834 N 153RD ST
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City | BENNINGTON
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State | NE
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Zip | 68007-1565
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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 | OWNER/PHYSICAL THERAPIST
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Name | LAURA ANDERSON
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Credential | DPT
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Telephone | 402-210-6120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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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 | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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