Organization
COMMUNITY REHAB, INC.
Active
Other names
Community Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
MARY J THEILER MPT (OWNER/PHYSICAL THERAPIST)
(402) 721-3908
Entity
Organization
Contact information
Practice address
14450 EAGLE RUN DR, SUITE 130, OMAHA, NE 68116-1493
(402) 504-1330
(402) 504-1335
Mailing address
14450 EAGLE RUN DR STE 130, OMAHA, NE 68116-1493
(402) 504-1330
(402) 504-1335
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
N/A
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01805
BLUE CROSS BLUE SHIELD
NE
05
—
0586339
—
IA
05
—
10025040000
—
NE
01
—
193153205
DOL-OWCP
NE
05
—
6400610
—
NE
01
—
83270
COVENTRY
NE
01
—
S561
MIDLANDS CHOICE
NE
Enumeration date
08/29/2006
Last updated
05/16/2008
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