Provider Demographics
NPI:1669609848
Name:GULIZIA, MARISA JEAN (DPT)
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:JEAN
Last Name:GULIZIA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MARISA
Other - Middle Name:JEAN
Other - Last Name:BRETSCHNEIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:13809 INDUSTRIAL RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-1117
Mailing Address - Country:US
Mailing Address - Phone:402-932-7111
Mailing Address - Fax:402-932-6878
Practice Address - Street 1:13809 INDUSTRIAL RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-1117
Practice Address - Country:US
Practice Address - Phone:402-932-7111
Practice Address - Fax:402-932-6878
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE27662251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic