Provider Demographics
NPI:1144065384
Name:MENESES, ATHENA RACHELLE (DPT, PT)
Entity type:Individual
Prefix:DR
First Name:ATHENA
Middle Name:RACHELLE
Last Name:MENESES
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PLATTSMOUTH
Mailing Address - State:NE
Mailing Address - Zip Code:68048-1313
Mailing Address - Country:US
Mailing Address - Phone:402-730-6644
Mailing Address - Fax:
Practice Address - Street 1:306 N 7TH ST
Practice Address - Street 2:
Practice Address - City:PLATTSMOUTH
Practice Address - State:NE
Practice Address - Zip Code:68048-1310
Practice Address - Country:US
Practice Address - Phone:402-296-2196
Practice Address - Fax:402-296-2197
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4506261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy