Organization
COMMUNITY REHAB, INC
Active
Other names
Community Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
MARY J THEILER MPT (OWNER/PHYSICAL THERAPIST)
(402) 721-3908
Entity
Organization
Contact information
Practice address
8002 S 84TH ST, SUITE 1, LAVISTA, NE 68128-3302
(402) 331-6444
(402) 331-9080
Mailing address
8002 S 84TH ST STE 1, LAVISTA, NE 68128-3302
(402) 331-6444
(402) 331-9080
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
N/A
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01805
BLUE CROSS BLUE SHIELD
NE
05
—
0586339
—
IA
01
—
193153201
DOL-OWCP
NE
05
—
6400076
—
NE
01
—
83270
COVENTRY
NE
01
—
S561
MIDLANDS CHOICE
NE
Enumeration date
08/29/2006
Last updated
05/16/2008
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