Provider Demographics
NPI:1255436374
Name:COLUMBUS PHYSICAL THERAPY, P.C.
Entity type:Organization
Organization Name:COLUMBUS PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR INCOME MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ENGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-564-5456
Mailing Address - Street 1:3211 25TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-2473
Mailing Address - Country:US
Mailing Address - Phone:402-564-5456
Mailing Address - Fax:402-562-6350
Practice Address - Street 1:3211 25TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-2473
Practice Address - Country:US
Practice Address - Phone:402-564-5456
Practice Address - Fax:402-562-6350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1647225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1801820840OtherNPI#
NE1801820840OtherNPI#
NE=========00Medicaid