Provider Demographics
NPI:1538502364
Name:GRUENES, MARIE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:
Last Name:GRUENES
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:
Other - Last Name:MASEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:11414 W CENTER RD
Mailing Address - Street 2:125
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-4486
Mailing Address - Country:US
Mailing Address - Phone:402-933-3360
Mailing Address - Fax:402-933-3363
Practice Address - Street 1:11414 WEST CENTER ROAD
Practice Address - Street 2:125
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144
Practice Address - Country:US
Practice Address - Phone:402-933-3360
Practice Address - Fax:402-933-3363
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12412251G0304X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics