MEDICARE: PHYSIOTHERAPY ASSOCIATES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275563645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSIOTHERAPY ASSOCIATES INC

Provider Business Mailing Address
First Line	:	5017 LEAVENWORTH ST
Second Line	:	SUITE 101
City	:	OMAHA
State	:	NE
Zip	:	68106-1438
Country	:	US
Telephone Number	:	402-553-5332
Fax Number	:

Provider Business Practice Location Address
First Line	:	5017 LEAVENWORTH ST
Second Line	:	SUITE 101
City	:	OMAHA
State	:	NE
Zip	:	68106-1438
Country	:	US
Telephone Number	:	402-553-5332
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	DENNIS FITZPATRICK
Credential	:
Telephone Number	:	610-644-7824

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	02/27/2009

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Directions to “PHYSIOTHERAPY ASSOCIATES INC ” Practice Location

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