Provider Demographics
NPI:1063250652
Name:BPT DIAGNOSTICS LLC
Entity type:Organization
Organization Name:BPT DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORAVEC
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:402-677-9169
Mailing Address - Street 1:3510 AVENUE B
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-4333
Mailing Address - Country:US
Mailing Address - Phone:308-633-7878
Mailing Address - Fax:308-633-7018
Practice Address - Street 1:3510 AVENUE B
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4333
Practice Address - Country:US
Practice Address - Phone:308-633-7878
Practice Address - Fax:308-633-7018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, ClinicalGroup - Multi-Specialty