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NPI Code Detail

MEDICARE: WORKING BACK INSTITUTE INC

MEDICARE: WORKING BACK INSTITUTE 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
1225100000XPhysical Therapist382NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14797990001OTHERREGION D DMERC SUPPLIER

General Provider Information

NPI Number : 1336181957
Entity Type Code : Organization
Provider Name (Legal Business Name) : WORKING BACK INSTITUTE INC
Provider Business Mailing Address
First Line : 407 BLACK HILLS AVE
Second Line :
City : ALLIANCE
State : NE
Zip : 69301-3243
Country : US
Telephone Number : 308-762-6564
Fax Number : 308-762-3747
Provider Business Practice Location Address
First Line : 407 BLACK HILLS AVE
Second Line :
City : ALLIANCE
State : NE
Zip : 69301-3243
Country : US
Telephone Number : 308-762-6564
Fax Number : 308-762-3747
Authorized Official
Title or Position : PRESIDENT/OWNER
Name : KAREN SUE BROWN
Credential : PT
Telephone Number : 308-762-6564
Provider Enumeration Date : 06/11/2006
Last Update Date : 01/22/2013

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