Individual
MR. MARK ALLEN SUNDERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, GCS
Contact information
Practice address
6315 O ST, LINCOLN, NE 68510-2237
(402) 489-6591
(402) 484-4767
Mailing address
4001 S 82ND STREET CIR, LINCOLN, NE 68506-5938
(402) 486-2477
(402) 484-4767
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
659
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2223
GERIATRIC SPECIALIST LICE
NE
01
—
48110
NATIONAL LISCENSE
NE
Enumeration date
03/28/2007
Last updated
07/08/2007
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