Individual
MARK T RATHJEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
17660 WRIGHT STREET, SUITES 9/10, OMAHA, NE 68130
(402) 933-4027
(402) 933-5027
Mailing address
17660 WRIGHT STREET, SUITES 9/10, OMAHA, NE 68130
(402) 933-4027
(402) 933-5027
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
2494
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02170
BCBS
—
05
—
10025428900
—
NE
05
—
10025429000
—
NE
05
—
10025429100
—
NE
05
—
10025429200
—
NE
05
—
10025429300
—
NE
Enumeration date
01/18/2007
Last updated
12/22/2015
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