Provider Demographics
NPI:1386783181
Name:SOUTHWEST NEBRASKA PHYSICAL THERAPY, P.C.
Entity type:Organization
Organization Name:SOUTHWEST NEBRASKA PHYSICAL THERAPY, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SHEETS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-344-8383
Mailing Address - Street 1:PO BOX 789
Mailing Address - Street 2:
Mailing Address - City:MCCOOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-0789
Mailing Address - Country:US
Mailing Address - Phone:308-340-8722
Mailing Address - Fax:
Practice Address - Street 1:302 CENTER AVE
Practice Address - Street 2:
Practice Address - City:CURTIS
Practice Address - State:NE
Practice Address - Zip Code:69025-0105
Practice Address - Country:US
Practice Address - Phone:308-367-4885
Practice Address - Fax:308-367-4899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026294001Medicaid
NE099350Medicare ID - Type Unspecified
NE10024959600Medicaid