Provider Demographics
NPI:1497076756
Name:WITTE, DANIEL JAMES (DPT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JAMES
Last Name:WITTE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:NE
Mailing Address - Zip Code:68037-0068
Mailing Address - Country:US
Mailing Address - Phone:402-234-3333
Mailing Address - Fax:402-234-3333
Practice Address - Street 1:1268 E HENRY STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:LOUISVILLE
Practice Address - State:NE
Practice Address - Zip Code:68037
Practice Address - Country:US
Practice Address - Phone:402-234-3333
Practice Address - Fax:844-272-6479
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2866225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1497076756OtherINDIVIDUAL NPI