Provider Demographics
NPI:1760415764
Name:HRUSKA CLINIC INC.
Entity Type:Organization
Organization Name:HRUSKA CLINIC INC.
Other - Org Name:HRUSKA CLINIC INC., RESTORATIVE PHYSICAL THERAPY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:HRUSKA
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:402-467-4545
Mailing Address - Street 1:5241 R ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-3422
Mailing Address - Country:US
Mailing Address - Phone:402-467-4545
Mailing Address - Fax:402-467-4580
Practice Address - Street 1:5241 R ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-3422
Practice Address - Country:US
Practice Address - Phone:402-467-4545
Practice Address - Fax:402-467-4580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE098853Medicare ID - Type UnspecifiedMEDICARE