Individual
STEPHANIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
13336 INDUSTRIAL RD, SUITE 105, OMAHA, NE 68137-1124
(402) 330-3211
(402) 330-5970
Mailing address
819 S 186TH ST, ELKHORN, NE 68022-5628
(402) 238-4885
(402) 238-4885
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2573
NE
225100000X
Physical Therapist
3865
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47065477701
—
NE
Enumeration date
06/10/2006
Last updated
07/08/2007
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