Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2982 | NE |
NPI | 1003100801 |
---|---|
Provider Name | Joshua Joseph Fitchner |
First Address | Hastings, NE 68901-9116 |
Second Address | Hastings, NE 68901-9116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2011 |
Last Update Date | 09/06/2011 |