Provider Demographics
NPI:1407510597
Name:O'BRIEN, DORIS ANN (PT)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:ANN
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:TILDEN
Mailing Address - State:NE
Mailing Address - Zip Code:68781-4760
Mailing Address - Country:US
Mailing Address - Phone:402-368-5343
Mailing Address - Fax:402-368-7746
Practice Address - Street 1:308 W 2ND ST
Practice Address - Street 2:
Practice Address - City:TILDEN
Practice Address - State:NE
Practice Address - Zip Code:68781-4760
Practice Address - Country:US
Practice Address - Phone:402-368-5343
Practice Address - Fax:402-368-7746
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3812251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic