Organization
OPTIMUM PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CASANDRA MARIE BAKER P.T., O.C.S. (OWNER, THERAPIST)
(402) 639-6708
Entity
Organization
Contact information
Practice address
13906 GOLD CIR, SUITE 103, OMAHA, NE 68144-2335
(402) 639-6708
(402) 614-4730
Mailing address
PO BOX 45502, OMAHA, NE 68145-0502
(402) 639-6708
(402) 614-4730
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
600
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39525
BCBS
NE
01
—
DF0781
RAILROAD MEDICARE
NE
01
—
F244879
MIDLANDS CHOICE
NE
Enumeration date
05/22/2007
Last updated
11/28/2007
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