Individual
JACQUELINE L RAUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3353 L ST, OMAHA, NE 68107-2500
(402) 354-7730
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1640
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025895900
—
NE
05
—
10025896000
—
NE
05
—
10025896100
—
NE
Enumeration date
10/01/2010
Last updated
02/01/2011
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