Individual
KAYLA MARIE MAMMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1276 SAND HILL RD, #2, LOUISVILLE, NE 68037
(402) 234-3333
Mailing address
2302 SCARBOROUGH DR, BELLEVUE, NE 68123-2082
(402) 821-7308
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
0014429
CO
225100000X
Physical Therapist
Primary
0014429
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285176636
INDIVIDUAL NPI
NE
Enumeration date
11/15/2016
Last updated
02/11/2019
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