Individual
MRS. BECKY LYNN MANCUSO-OLDEHOEFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT.
Contact information
Practice address
4101 WOOLWORTH AVE, OMAHA, NE 68105-1850
(402) 346-8800
Mailing address
11618 DOUGLAS ST, OMAHA, NE 68154-3129
(402) 827-0987
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2155
NE
Other
Enumeration date
06/15/2006
Last updated
07/08/2007
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