Individual
ERIC P NOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
12905 W DODGE RD, OMAHA, NE 68154-2145
(402) 991-7888
Mailing address
11414 W CENTER RD, STE 242, OMAHA, NE 68144-4487
(402) 991-7888
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
1870
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100250996-00
—
NE
01
—
1669663076
RENDERING PROVIDER ID
NE
01
—
277581
PERFORMING PROVIDER NUMBE
NE
Enumeration date
08/09/2007
Last updated
08/07/2018
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