Provider Demographics
NPI:1447022132
Name:HASTINGS PHYSICAL THERAPY
Entity type:Organization
Organization Name:HASTINGS PHYSICAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BAILEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-462-2665
Mailing Address - Street 1:3213 W NORTH FRONT ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-4026
Mailing Address - Country:US
Mailing Address - Phone:308-395-7252
Mailing Address - Fax:308-395-7063
Practice Address - Street 1:3213 W NORTH FRONT ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4026
Practice Address - Country:US
Practice Address - Phone:308-395-7252
Practice Address - Fax:308-395-7063
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HASTINGS PHYSICAL THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-25
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy