| NPI | 1346463700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMERLIN U. SODUSTA President & CEO 402-926-4088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 1177) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |