Provider Demographics
NPI:1578812616
Name:KOTTICH, ERIN THERESA (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:THERESA
Last Name:KOTTICH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 S 85TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9231
Mailing Address - Country:US
Mailing Address - Phone:402-423-7328
Mailing Address - Fax:
Practice Address - Street 1:5900 S 85TH ST STE 101
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9231
Practice Address - Country:US
Practice Address - Phone:402-423-7328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3160208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation