Provider Demographics
NPI:1538188552
Name:HORIZON SPINE REHABILITATION INC
Entity type:Organization
Organization Name:HORIZON SPINE REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROEHRS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:402-393-9390
Mailing Address - Street 1:8642 F ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-1639
Mailing Address - Country:US
Mailing Address - Phone:402-393-9390
Mailing Address - Fax:402-393-9388
Practice Address - Street 1:8642 F ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1639
Practice Address - Country:US
Practice Address - Phone:402-393-9390
Practice Address - Fax:402-393-9388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NE098899Medicare PIN