Provider Demographics
NPI:1508190240
Name:MONUMENT PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:MONUMENT PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRING
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:308-633-5361
Mailing Address - Street 1:2970 10TH ST
Mailing Address - Street 2:
Mailing Address - City:GERING
Mailing Address - State:NE
Mailing Address - Zip Code:69341-1763
Mailing Address - Country:US
Mailing Address - Phone:308-633-5361
Mailing Address - Fax:308-633-5365
Practice Address - Street 1:2970 10TH ST
Practice Address - Street 2:
Practice Address - City:GERING
Practice Address - State:NE
Practice Address - Zip Code:69341-1763
Practice Address - Country:US
Practice Address - Phone:308-633-5361
Practice Address - Fax:308-633-5365
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH PLATTE PHYSICAL THERAPY SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty