Provider Demographics
NPI:1750828935
Name:TEAM PHYSICAL THERAPY,P.C.
Entity Type:Organization
Organization Name:TEAM PHYSICAL THERAPY,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS & PERSONNEL
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:DENSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:308-872-5111
Mailing Address - Street 1:523 10TH ST
Mailing Address - Street 2:
Mailing Address - City:GOTHENBURG
Mailing Address - State:NE
Mailing Address - Zip Code:69138-1925
Mailing Address - Country:US
Mailing Address - Phone:308-537-3600
Mailing Address - Fax:308-537-3601
Practice Address - Street 1:523 10TH ST
Practice Address - Street 2:
Practice Address - City:GOTHENBURG
Practice Address - State:NE
Practice Address - Zip Code:69138-1925
Practice Address - Country:US
Practice Address - Phone:308-537-3600
Practice Address - Fax:308-537-3601
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEAM PHYSICAL THERAPY, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-25
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026075903Medicaid