Organization
COMMUNITY REHAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP D DAVIDSON PT (OWNER)
(402) 614-7775
Entity
Organization
Contact information
Practice address
4500 S 70TH ST, #115, LINCOLN, NE 68516-4283
(402) 817-1784
(402) 264-9611
Mailing address
4500 S 70TH ST, #115, LINCOLN, NE 68516-4283
(402) 817-1784
(402) 264-9611
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH3115
RR MEDICARE
NE
01
—
PENDING
NEBRASKA MEDICAID
NE
Enumeration date
01/19/2014
Last updated
01/19/2014
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