Provider Demographics
NPI:1891748570
Name:BEDNAR, BRUCE R (OTRL,CHT, CWCE)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:R
Last Name:BEDNAR
Suffix:
Gender:M
Credentials:OTRL,CHT, CWCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 N 86TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-3718
Mailing Address - Country:US
Mailing Address - Phone:402-484-7117
Mailing Address - Fax:
Practice Address - Street 1:6120 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-4735
Practice Address - Country:US
Practice Address - Phone:402-420-2626
Practice Address - Fax:402-420-6502
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE938225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE277285Medicare ID - Type Unspecified