MEDICARE: TEAM PHYSICAL THERAPY, P.C.

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

General Provider Information

NPI Number	:	1942747225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEAM PHYSICAL THERAPY, P.C.

Provider Business Mailing Address
First Line	:	PO BOX 846
Second Line	:
City	:	BURWELL
State	:	NE
Zip	:	68823-0846
Country	:	US
Telephone Number	:	308-346-5111
Fax Number	:	308-346-5111

Provider Business Practice Location Address
First Line	:	280 N 8TH AVE
Second Line	:
City	:	BURWELL
State	:	NE
Zip	:	68823-4168
Country	:	US
Telephone Number	:	308-346-5111
Fax Number	:	308-346-5111

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS & PERSONNEL
Name	:	JEFF DENSON
Credential	:	PT
Telephone Number	:	308-872-5111

Provider Enumeration Date	:	01/25/2017
Last Update Date	:	07/26/2017

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