Individual
MRS. DARA ANN WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
880 PARK DR, SPRINGFIELD, NE 68059-6845
(402) 253-3079
(402) 253-2631
Mailing address
4903 COUNTY ROAD P39, FORT CALHOUN, NE 68023-5077
(402) 660-7289
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2561
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2561
STATE LICENSE
NE
Enumeration date
06/20/2007
Last updated
07/06/2023
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