Provider Demographics
NPI:1053470823
Name:HORIZON PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:HORIZON PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:JANSA
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:402-420-2500
Mailing Address - Street 1:1919 S. 40TH ST.
Mailing Address - Street 2:SUITE 335
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5248
Mailing Address - Country:US
Mailing Address - Phone:402-420-2500
Mailing Address - Fax:402-420-2501
Practice Address - Street 1:1919 S. 40TH ST.
Practice Address - Street 2:SUITE 335
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5248
Practice Address - Country:US
Practice Address - Phone:402-420-2500
Practice Address - Fax:402-420-2501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE225100000X
NE16552251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty