Provider Demographics
NPI:1710911425
Name:WENBURG, AARON C (DPT)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:C
Last Name:WENBURG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 W LEOTA ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-6532
Mailing Address - Country:US
Mailing Address - Phone:308-534-5590
Mailing Address - Fax:308-534-5570
Practice Address - Street 1:624 W LEOTA ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6532
Practice Address - Country:US
Practice Address - Phone:308-534-5590
Practice Address - Fax:308-534-5570
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2124225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE02343OtherBLUE CROSS
NE281312Medicare PIN