Organization
OPTIMUM PHYSICAL THERAPY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CASANDRA MARIE BAKER P.T., O.C.S (OWNER-THERAPIST)
(402) 639-6708
Entity
Organization
Contact information
Practice address
13906 GOLD CIR, SUITE 103, OMAHA, NE 68144-2335
(402) 639-6708
(402) 614-4730
Mailing address
PO BOX 45502, OMAHA, NE 68145-0502
(402) 639-6708
(402) 614-4730
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF0781
RAILROAD MEDICARE
NE
01
—
F24487
MIDLANDS CHOICE
NE
Enumeration date
02/01/2008
Last updated
06/05/2008
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