Provider Demographics
NPI:1508144205
Name:WOEHLER, MARCI DANAE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:MARCI
Middle Name:DANAE
Last Name:WOEHLER
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 1:221 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NE
Mailing Address - Zip Code:68787-2003
Mailing Address - Country:US
Mailing Address - Phone:402-440-2123
Mailing Address - Fax:
Practice Address - Street 1:401 W DARLENE ST
Practice Address - Street 2:
Practice Address - City:HARTINGTON
Practice Address - State:NE
Practice Address - Zip Code:68739-4510
Practice Address - Country:US
Practice Address - Phone:402-254-3985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE960225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant