Provider Demographics
NPI:1992326490
Name:WEHRMAN, DOUGLAS (PT)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:
Last Name:WEHRMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30471 ROAD Q
Mailing Address - Street 2:
Mailing Address - City:EDGAR
Mailing Address - State:NE
Mailing Address - Zip Code:68935-3121
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:520 E 10TH ST
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:NE
Practice Address - Zip Code:68978-1225
Practice Address - Country:US
Practice Address - Phone:402-314-1735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2912225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty