Provider Demographics
NPI:1497032031
Name:MASON, RITA M (PTA)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:M
Last Name:MASON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 AGNEW RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:NE
Mailing Address - Zip Code:68366-3000
Mailing Address - Country:US
Mailing Address - Phone:402-944-2468
Mailing Address - Fax:
Practice Address - Street 1:700 S HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:NE
Practice Address - Zip Code:68028-7970
Practice Address - Country:US
Practice Address - Phone:402-332-3446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE499225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant