Individual
MRS. JORDAN SUE BRESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
706 EWING AVENUE, GENOA, NE 68640
(402) 993-4599
(402) 993-7024
Mailing address
706 EWING AVENUE, GENOA, NE 68640
(402) 993-4599
(402) 993-7024
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
3972
NE
225100000X
Physical Therapist
3972
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3972
PT LICENSE
NE
Enumeration date
06/25/2019
Last updated
06/12/2023
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