Provider Demographics
NPI:1043742067
Name:RECH, NICHOLAS (PT,DPT,MS,ATC,CSCS)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:RECH
Suffix:
Gender:M
Credentials:PT,DPT,MS,ATC,CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 INDEPENDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-2258
Mailing Address - Country:US
Mailing Address - Phone:402-641-3176
Mailing Address - Fax:402-817-5568
Practice Address - Street 1:2116 INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-2258
Practice Address - Country:US
Practice Address - Phone:402-641-3176
Practice Address - Fax:402-817-5568
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2021-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3680225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist