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General NPI Number Information
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NPI Number | 1972630069
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Entity Type | Individual
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Provider Name | MELISSA E GERARD P.T.
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Gender | Female
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 2728 N 108TH ST STE 103
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City | OMAHA
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State | NE
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Zip | 68164-3763
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Country | US
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Telephone | 402-939-7939
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Fax |
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Provider Business Mailing Address
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Address Line | 7100 W CENTER RD
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City | OMAHA
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State | NE
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Zip | 68106-2714
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Country | US
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Telephone | 402-506-9127
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Fax | 402-315-2707
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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 | 03968
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License Number State | IA
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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 | 2292
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License Number State | NE
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