Individual
JENNIFER J COLGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
4110 S 144TH ST, OMAHA, NE 68137-1013
(402) 861-6683
(402) 861-6689
Mailing address
4110 S 144TH ST, OMAHA, NE 68137-1013
(402) 861-6683
(402) 861-6689
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3179
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NE
Enumeration date
11/21/2012
Last updated
07/17/2013
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