Provider Demographics
NPI:1679787634
Name:CORDERY, CATHERINE ANN (DPT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:CORDERY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 N 144TH AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-1935
Mailing Address - Country:US
Mailing Address - Phone:402-350-1341
Mailing Address - Fax:
Practice Address - Street 1:625 N 144TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154
Practice Address - Country:US
Practice Address - Phone:402-934-8688
Practice Address - Fax:402-934-8689
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2221225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist