Basic Information
| Provider Information | |||||||||
| NPI: | 1639266307 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | YORK PHYSICAL THERAPY INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2835 N NEBRASKA AVE | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | NE | ||||||||
| PostalCode: | 684678096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023622929 | ||||||||
| FaxNumber: | 4023623133 | ||||||||
| Practice Location | |||||||||
| Address1: | 2835 N NEBRASKA AVE | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | NE | ||||||||
| PostalCode: | 684678096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023622929 | ||||||||
| FaxNumber: | 4023623133 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SMITH | ||||||||
| AuthorizedOfficialFirstName: | BRETT | ||||||||
| AuthorizedOfficialMiddleName: | I | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4023622929 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | CG6190 | 01 | NE | RR MEDICARE | OTHER |