Provider Demographics
NPI:1952417149
Name:HASH, JUSTIN A (PT)
Entity Type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:A
Last Name:HASH
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 1:1305 S 70TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4247
Mailing Address - Country:US
Mailing Address - Phone:402-484-7162
Mailing Address - Fax:402-488-4943
Practice Address - Street 1:1305 S 70TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4247
Practice Address - Country:US
Practice Address - Phone:402-484-7162
Practice Address - Fax:402-488-4943
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEP00165975OtherMEDICARE RR
NE39929OtherBCBS OF NEBRASKA
NEP00165975OtherMEDICARE RR
NE099668Medicare PIN
NE277286Medicare PIN
NE39929OtherBCBS OF NEBRASKA