Organization
ACTIVATE PT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHANIEL ALLAN WISSINK PT, DPT, MATCS (OWNER)
(402) 580-1606
Entity
Organization
Contact information
Practice address
9015 ARBOR ST STE 155, OMAHA, NE 68124-2072
(402) 580-1606
Mailing address
9015 ARBOR ST STE 155, OMAHA, NE 68124-2072
(531) 213-2666
(531) 213-2386
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
04/06/2022
Last updated
02/07/2023
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