Individual
MADISON A BASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
17809 PIERCE PLZ, OMAHA, NE 68130-1035
(402) 955-8181
Mailing address
PO BOX 24607, OMAHA, NE 68124-0607
(402) 955-5400
(402) 955-3674
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4420
NE
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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