Individual
MICHAEL STODDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1405 N 205 STREET, 140, ELKHORN, NE 68022
(402) 289-5013
(402) 289-5018
Mailing address
1405 N 205TH ST, 140, ELKHORN, NE 68022-4740
(402) 289-5013
(402) 289-5018
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
02755
IA
225100000X
Physical Therapist
Primary
1604
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025112300
—
NE
01
—
216813
COVENTRY
—
01
—
39960
BCBS
NE
01
—
41213595668022A002
TRIWEST
NE
Enumeration date
04/26/2006
Last updated
09/21/2021
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