| NPI | 1275905689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY J GARDNER Sole Member 402-879-0109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NE 1484) |
| Enumeration Date | 2015-10-25 |
| Last Update Date | 2020-01-07 |