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NPI Code Detail

MEDICARE: MRS. MICHELLE M SPICKA DPT

MEDICARE: MRS. MICHELLE M SPICKA DPT
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 Therapist2013NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12013OTHERNESTATE LICENSE NUMBER

General Provider Information

NPI Number : 1548272743
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE M SPICKA DPT
Provider Business Mailing Address
First Line : 4231 BINGHAM LN
Second Line :
City : LINCOLN
State : NE
Zip : 68516-2947
Country : US
Telephone Number : 402-429-3150
Fax Number :
Provider Business Practice Location Address
First Line : 4911 N 26TH ST
Second Line : SUITE 100
City : LINCOLN
State : NE
Zip : 68521-4739
Country : US
Telephone Number : 402-477-3110
Fax Number : 402-477-4990
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. MICHELLE M SPICKA DPT” Practice Location

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