Provider Demographics
NPI:1417260449
Name:PHYSICAL THERAPY WORKS INC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY WORKS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:OSTDIEK
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:402-614-8042
Mailing Address - Street 1:3407 S 84TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-3325
Mailing Address - Country:US
Mailing Address - Phone:402-614-8042
Mailing Address - Fax:402-614-8043
Practice Address - Street 1:3407 S 84TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3325
Practice Address - Country:US
Practice Address - Phone:402-614-8042
Practice Address - Fax:402-614-8043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-19
Last Update Date:2011-01-21
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
NE10025878400Medicaid
NENA1773Medicare PIN