Provider Demographics
NPI:1063406213
Name:DEE, JEFFREY R (MSPT)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:R
Last Name:DEE
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 S. 40TH ST.
Mailing Address - Street 2:SUITE 335
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5248
Mailing Address - Country:US
Mailing Address - Phone:402-420-2500
Mailing Address - Fax:402-420-2501
Practice Address - Street 1:1919 S. 40TH ST.
Practice Address - Street 2:SUITE 335
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5248
Practice Address - Country:US
Practice Address - Phone:402-420-2500
Practice Address - Fax:402-420-2501
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2047225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE39533OtherBCBS
NE39533OtherBCBS
P35544Medicare UPIN