Provider Demographics
NPI:1841256393
Name:WEBER, JERRY E (PT, ATC)
Entity type:Individual
Prefix:MR
First Name:JERRY
Middle Name:E
Last Name:WEBER
Suffix:
Gender:M
Credentials:PT, ATC
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:7621 BALDWIN AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68507-2922
Mailing Address - Country:US
Mailing Address - Phone:402-472-2276
Mailing Address - Fax:402-472-2006
Practice Address - Street 1:UNIVERISITY OF NEBRASKA ATHLETIC MEDICINE CENTER
Practice Address - Street 2:OSBORNE ATHLETIC COMPLEX
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68588-0128
Practice Address - Country:US
Practice Address - Phone:402-472-2276
Practice Address - Fax:402-472-2006
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3502251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports