Provider Demographics
NPI:1053531756
Name:SANDHILLS PHYSICAL THERAPY AND SPORTS REHAB P.C.
Entity type:Organization
Organization Name:SANDHILLS PHYSICAL THERAPY AND SPORTS REHAB P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER/ PT
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:C
Authorized Official - Last Name:WENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:308-534-5590
Mailing Address - Street 1:624 W LEOTA ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-6532
Mailing Address - Country:US
Mailing Address - Phone:308-534-5590
Mailing Address - Fax:308-534-5570
Practice Address - Street 1:624 W LEOTA ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6532
Practice Address - Country:US
Practice Address - Phone:308-534-5590
Practice Address - Fax:308-534-5570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty