Individual
KENNETH R WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
12020 PACIFIC ST, OMAHA, NE 68154-3507
(800) 259-9897
Mailing address
PO BOX 1695, LEADVILLE, CO 80461-1695
(970) 445-7856
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0013732
CO
Other
Enumeration date
02/01/2023
Last updated
02/01/2023
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