Provider Demographics
NPI:1093326258
Name:SANDHILLS PHYSICAL THERAPY AND SPORTS REHAB P.C.
Entity Type:Organization
Organization Name:SANDHILLS PHYSICAL THERAPY AND SPORTS REHAB P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:LAYNE
Authorized Official - Last Name:BLANK-PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-534-5590
Mailing Address - Street 1:616 W LEOTA ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-6532
Mailing Address - Country:US
Mailing Address - Phone:308-534-5590
Mailing Address - Fax:308-534-5570
Practice Address - Street 1:701 4TH AVE STE 1
Practice Address - Street 2:
Practice Address - City:HOLDREGE
Practice Address - State:NE
Practice Address - Zip Code:68949-2255
Practice Address - Country:US
Practice Address - Phone:308-248-0303
Practice Address - Fax:308-248-0304
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SANDHILLS PHYSICAL THERAPY AND SPORTS REHAB P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026431302Medicaid