Provider Demographics
NPI:1205442076
Name:ENCOMPASS PHYSICAL THERAPY AND FITNESS LLC
Entity type:Organization
Organization Name:ENCOMPASS PHYSICAL THERAPY AND FITNESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-250-2892
Mailing Address - Street 1:1340 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:NE
Mailing Address - Zip Code:69162-2060
Mailing Address - Country:US
Mailing Address - Phone:308-254-2225
Mailing Address - Fax:308-254-5000
Practice Address - Street 1:1340 10TH AVE
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NE
Practice Address - Zip Code:69162-2060
Practice Address - Country:US
Practice Address - Phone:308-254-2225
Practice Address - Fax:308-254-5000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-17
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy