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General NPI Number Information
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NPI Number | 1902577992
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Entity Type | Organization
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Legal Business Name | HEARTLAND NEUROLOGICAL THERAPY AND WELLNESS CENTER LLC
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Dates
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Enumeration Date | 09/21/2021
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Last Update Date | 09/21/2021
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Provider Practice Location Address
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Address Line | 2650 RIVER ROAD DR
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City | WATERLOO
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State | NE
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Zip | 68069-2040
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Country | US
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Telephone | 402-319-0801
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Fax | 402-769-2908
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Provider Business Mailing Address
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Address Line | 1611 N 214TH ST
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City | ELKHORN
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State | NE
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Zip | 68022-1612
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Country | US
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Telephone | 402-319-0801
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | CHEROLYN M PRINCE
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Credential | DPT
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Telephone | 402-319-0801
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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 |
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License Number State |
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