Provider Demographics
NPI:1962740936
Name:BELLEVUE PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:BELLEVUE PHYSICAL THERAPY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:I
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-873-7411
Mailing Address - Street 1:2403 TOWNE CENTRE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-6413
Mailing Address - Country:US
Mailing Address - Phone:402-292-4000
Mailing Address - Fax:402-292-4001
Practice Address - Street 1:2403 TOWNE CENTRE DR STE 300
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-6413
Practice Address - Country:US
Practice Address - Phone:402-292-4000
Practice Address - Fax:402-292-4001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy