Individual
VANESSA PINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11506 NICHOLAS ST, STE 110, OMAHA, NE 68154-4407
(877) 230-3885
(402) 505-9753
Mailing address
2449 E WATERS EDGE DR, COLUMBIA CITY, IN 46725-8996
(260) 609-8749
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305207479
VA
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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