Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 3120 | NE |
NPI | 1093186058 |
---|---|
Provider Name | Brooke Riha |
First Address | Atkinson, NE 68713-4801 |
Second Address | Atkinson, NE 68713-4801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2015 |
Last Update Date | 15/10/2015 |