Provider Demographics
NPI:1689317380
Name:WESTERBY, COLEMAN
Entity Type:Individual
Prefix:
First Name:COLEMAN
Middle Name:
Last Name:WESTERBY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 S 31ST ST APT 5
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-2076
Mailing Address - Country:US
Mailing Address - Phone:308-850-3871
Mailing Address - Fax:
Practice Address - Street 1:8642 F ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1639
Practice Address - Country:US
Practice Address - Phone:402-393-9390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist