Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 2647 | NV |
Y | 225100000X | Physical Therapist | 3310 | NE |
NPI | 1003232398 |
---|---|
Provider Name | Joseph Osovski |
First Address | Omaha, NE 68106-3718 |
Second Address | Omaha, NE 68106-3718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2014 |
Last Update Date | 11/03/2014 |