Organization
COMMUNITY REHAB, INC
Active
Other names
Community Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JANE THEILER MPT (OWNER/PHYSICAL THERAPIST)
(402) 721-3908
Entity
Organization
Contact information
Practice address
410 E 22ND ST, FREMONT, NE 68025-2609
(402) 721-3908
(402) 721-4047
Mailing address
410 E 22ND ST, FREMONT, NE 68025-2609
(402) 721-3908
(402) 721-4047
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01805
BLUE CROSS BLUE SHIELD
NE
05
—
0586339
—
IA
01
—
193153200
DOL-OWCP
NE
01
—
83270
COVENTRY
NE
01
—
S561
MIDLANDS CHOICE
NE
Enumeration date
08/15/2005
Last updated
10/19/2016
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