Provider Demographics
NPI:1629359278
Name:LANIK, AMY (PTA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:LANIK
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
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Mailing Address - Street 1:13336 INDUSTRIAL RD
Mailing Address - Street 2:105
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-1124
Mailing Address - Country:US
Mailing Address - Phone:402-330-3211
Mailing Address - Fax:402-330-5970
Practice Address - Street 1:13336 INDUSTRIAL RD
Practice Address - Street 2:105
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-1124
Practice Address - Country:US
Practice Address - Phone:402-330-3211
Practice Address - Fax:402-330-5970
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2012-07-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE1048225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant