Provider Demographics
NPI:1396963815
Name:ZIMMERMAN, JEFFREY JOHN (PT)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:JOHN
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3405 S 117TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-4642
Mailing Address - Country:US
Mailing Address - Phone:402-981-1407
Mailing Address - Fax:
Practice Address - Street 1:2728 N 108TH ST STE 103
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-3763
Practice Address - Country:US
Practice Address - Phone:402-939-7939
Practice Address - Fax:402-939-7940
Is Sole Proprietor?:No
Enumeration Date:2007-04-22
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15072251S0007X, 2251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic