Provider Demographics
NPI:1740503739
Name:CODDINGTON PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:CODDINGTON PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:JONATHAN
Authorized Official - Last Name:MOELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT BS
Authorized Official - Phone:402-826-2255
Mailing Address - Street 1:1550 S CODDINGTON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68522-4402
Mailing Address - Country:US
Mailing Address - Phone:402-423-0303
Mailing Address - Fax:402-423-0202
Practice Address - Street 1:1550 S CODDINGTON AVE
Practice Address - Street 2:SUITE C
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68522-4402
Practice Address - Country:US
Practice Address - Phone:402-423-0303
Practice Address - Fax:402-423-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-05
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty