Provider Demographics
NPI:1922005578
Name:RICKARD, WENDY RENEE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:RENEE
Last Name:RICKARD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 W NORTH FRONT ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-4026
Mailing Address - Country:US
Mailing Address - Phone:308-381-2424
Mailing Address - Fax:308-381-3646
Practice Address - Street 1:3213 W NORTH FRONT ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4026
Practice Address - Country:US
Practice Address - Phone:308-381-2424
Practice Address - Fax:308-381-3646
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2276225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist