Provider Demographics
NPI:1396948758
Name:PRAEUNER PHYSICAL THERAPY, L.L.C.
Entity type:Organization
Organization Name:PRAEUNER PHYSICAL THERAPY, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:PRAEUNER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:402-316-9566
Mailing Address - Street 1:207 N WERNER ST
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:NE
Mailing Address - Zip Code:68715-4433
Mailing Address - Country:US
Mailing Address - Phone:402-316-9566
Mailing Address - Fax:402-379-0583
Practice Address - Street 1:207 N WERNER ST
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:NE
Practice Address - Zip Code:68715-4433
Practice Address - Country:US
Practice Address - Phone:402-316-9566
Practice Address - Fax:402-379-0583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1325261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE39796OtherBCBS
NE10025380800Medicaid
NE099817Medicare ID - Type Unspecified