Individual
MRS. MARIAN JEAN LORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
14441 DUPONT CT, SUITE 102, OMAHA, NE 68144-2153
(402) 334-6213
(402) 334-6218
Mailing address
14441 DUPONT CT, SUITE 102, OMAHA, NE 68144-2153
(402) 334-6213
(402) 334-6218
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
712
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09205
BLUE CROSS
NE
05
—
47084030832
—
NE
01
—
F247007
MIDLANDS CHOICE
NE
01
—
NA1244001
MEDICARE PTAN
NE
Enumeration date
03/15/2006
Last updated
03/11/2009
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