Provider Demographics
NPI:1205675725
Name:LEBER, ASPEN R (PT)
Entity type:Individual
Prefix:
First Name:ASPEN
Middle Name:R
Last Name:LEBER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ASPEN
Other - Middle Name:R
Other - Last Name:ROLFES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1651 N 86TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-3719
Mailing Address - Country:US
Mailing Address - Phone:402-484-7117
Mailing Address - Fax:
Practice Address - Street 1:1900 K ST STE 170
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-1054
Practice Address - Country:US
Practice Address - Phone:531-204-8810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-23
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4614225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist