Individual
GINA MARIE SUKUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA, LMT
Contact information
Practice address
510 BRADFORD ST, SEWARD, NE 68434-1708
(402) 643-0711
Mailing address
510 BRADFORD ST, SEWARD, NE 68434-1708
(402) 643-0711
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1799
NE
Other
Enumeration date
05/24/2021
Last updated
05/24/2021
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