Provider Demographics
NPI:1528174711
Name:LINN, JOHN M (PT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:M
Last Name:LINN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1651 N. 86TH STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-3719
Mailing Address - Country:US
Mailing Address - Phone:402-484-7117
Mailing Address - Fax:
Practice Address - Street 1:1651 N. 86TH STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-3719
Practice Address - Country:US
Practice Address - Phone:402-484-7117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20852251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE094647002Medicare PIN