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NPI Code Detail

MEDICARE: LINCOLN PHYSICAL THERAPY AND SPORTS REHAB LLC

MEDICARE: LINCOLN PHYSICAL THERAPY AND SPORTS REHAB LLC
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
1332B00000XDurable Medical Equipment & Medical SuppliesNE
2225100000XPhysical Therapist0773441DPCNE

General Provider Information

NPI Number : 1891846572
Entity Type Code : Organization
Provider Name (Legal Business Name) : LINCOLN PHYSICAL THERAPY AND SPORTS REHAB LLC
Provider Business Mailing Address
First Line : 6940 VAN DORN ST STE 103
Second Line :
City : LINCOLN
State : NE
Zip : 68506-2858
Country : US
Telephone Number : 402-483-4709
Fax Number : 402-483-4097
Provider Business Practice Location Address
First Line : 2550 SUPERIOR ST STE 100
Second Line :
City : LINCOLN
State : NE
Zip : 68521-4155
Country : US
Telephone Number : 402-476-2600
Fax Number :
Authorized Official
Title or Position : OWNER/ PT
Name : CHAD WEMHOFF
Credential :
Telephone Number : 402-421-2700
Provider Enumeration Date : 01/16/2007
Last Update Date : 12/02/2019

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Directions to “LINCOLN PHYSICAL THERAPY AND SPORTS REHAB LLC ” Practice Location

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