Provider Demographics
NPI:1609131226
Name:WILLIAMS, BRETT G (PT)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:G
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 S 86TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9277
Mailing Address - Country:US
Mailing Address - Phone:402-327-9000
Mailing Address - Fax:402-327-9003
Practice Address - Street 1:1550 S CODDINGTON AVE STE C
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68522-4402
Practice Address - Country:US
Practice Address - Phone:402-423-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3089225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist