Provider Demographics
NPI:1396878245
Name:PLATTE VALLEY PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:PLATTE VALLEY PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-532-5480
Mailing Address - Street 1:1001 S COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-6138
Mailing Address - Country:US
Mailing Address - Phone:308-532-5480
Mailing Address - Fax:308-532-5480
Practice Address - Street 1:1001 S COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6138
Practice Address - Country:US
Practice Address - Phone:308-532-5480
Practice Address - Fax:308-532-5480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEF231692OtherMIDLANDS CHOICE GOUP #
NE10024973400Medicaid
NECK7267OtherRAILROAD MEDICARE GROUP #
NEF231692OtherMIDLANDS CHOICE GOUP #