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NPI Code Detail

MEDICARE: DOROTHY JANE DRUECKER PT

MEDICARE: DOROTHY JANE DRUECKER PT
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 Therapist133NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
102015OTHERNEBCBS OF NE

General Provider Information

NPI Number : 1760423404
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOROTHY JANE DRUECKER PT
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 :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2006
Last Update Date : 07/09/2007

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