Organization
WELLSPRING PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAUREN M POTACH P.T. (PHYSICAL THERAPIST)
(402) 934-9711
Entity
Organization
Contact information
Practice address
17055 FRANCES ST, #102, OMAHA, NE 68130-4655
(402) 934-9711
Mailing address
17055 FRANCES ST, #102, OMAHA, NE 68130-4655
(402) 934-9711
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025266100
—
NE
Enumeration date
02/06/2007
Last updated
05/31/2011
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