Organization
GO PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENDRA BRUMMUND (REVENUE CYCLE DIRECTOR)
(308) 675-1853
Entity
Organization
Contact information
Practice address
620 N DIERS AVE, SUITE 300, GRAND ISLAND, NE 68803-4985
(308) 382-0344
(308) 382-3241
Mailing address
PO BOX 5285, GRAND ISLAND, NE 68802-5285
(308) 382-0344
(308) 382-3241
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
681
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100250456-00
—
NE
01
—
NA2070
MEDICARE PTAN
NE
Enumeration date
05/24/2005
Last updated
09/03/2024
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