Provider Demographics
NPI:1306813241
Name:BAMESBERGER, BETH
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:BAMESBERGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:BAMESBERGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:2835 N NEBRASKA AVE
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:NE
Mailing Address - Zip Code:68467-8096
Mailing Address - Country:US
Mailing Address - Phone:402-362-2929
Mailing Address - Fax:
Practice Address - Street 1:810 N DIERS AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4968
Practice Address - Country:US
Practice Address - Phone:308-398-5170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE486225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist