| NPI | 1063867984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE STODDEN President / Owner 402-289-5013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 2556) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 1604) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2016-04-28 |