Individual
ABHA C SUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
11623 ARBOR ST, OMAHA, NE 68144-2981
(866) 334-1919
(402) 334-6016
Mailing address
728 W JACKSON BLVD APT 722, CHICAGO, IL 60661-5477
(314) 239-6051
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2007010470
MO
Other
Enumeration date
04/26/2007
Last updated
01/27/2014
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