Provider Demographics
NPI:1265105753
Name:NEW HORIZONS O & P NORTH PLATTE LLC
Entity type:Organization
Organization Name:NEW HORIZONS O & P NORTH PLATTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-698-0500
Mailing Address - Street 1:5609 1ST AVE STE A-2
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-2436
Mailing Address - Country:US
Mailing Address - Phone:308-698-0500
Mailing Address - Fax:
Practice Address - Street 1:2509 HALLIGAN DR STE F
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-7858
Practice Address - Country:US
Practice Address - Phone:308-856-9292
Practice Address - Fax:308-402-0011
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW HORIZONS ORTHOTICS & PROSTHETICS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-29
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier