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Individual

MISTY WOLTMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
3213 W. NORTH FRONT ST., GRAND ISLAND, NE 68803
(308) 381-2424
(308) 381-3646
Mailing address
3213 W. NORTH FRONT ST., GRAND ISLAND, NE 68803
(308) 381-2424
(308) 381-3646

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2380
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
47-0707622-00
NE
05
47-0707622-01
NE
Enumeration date
02/07/2007
Last updated
06/18/2020
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