Provider Demographics
NPI:1336181957
Name:WORKING BACK INSTITUTE INC
Entity Type:Organization
Organization Name:WORKING BACK INSTITUTE INC
Other - Org Name:ALLIANCE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:308-762-6564
Mailing Address - Street 1:407 BLACK HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:NE
Mailing Address - Zip Code:69301-3243
Mailing Address - Country:US
Mailing Address - Phone:308-762-6564
Mailing Address - Fax:308-762-3747
Practice Address - Street 1:407 BLACK HILLS AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:NE
Practice Address - Zip Code:69301-3243
Practice Address - Country:US
Practice Address - Phone:308-762-6564
Practice Address - Fax:308-762-3747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE382225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4797990001OtherREGION D DMERC SUPPLIER
098222Medicare ID - Type UnspecifiedGROUP NUMBER