Organization
PEDIATRIC THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CANDICE S MULLENDORE OTR/L (OWNER)
(402) 932-2782
Entity
Organization
Contact information
Practice address
10601 S 72ND ST, STE. 103, PAPILLION, NE 68046-3407
(402) 932-2782
(402) 932-2705
Mailing address
10601 S 72ND ST, STE. 103, PAPILLION, NE 68046-3407
(402) 932-2782
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/04/2008
Last updated
07/02/2015
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