Provider Demographics
NPI:1538257274
Name:KUHFAHL, ROGER JAMES (PT)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:JAMES
Last Name:KUHFAHL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 S 133RD PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5905
Mailing Address - Country:US
Mailing Address - Phone:402-330-8433
Mailing Address - Fax:402-330-8616
Practice Address - Street 1:9449 J STREET
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1223
Practice Address - Country:US
Practice Address - Phone:402-593-7345
Practice Address - Fax:402-593-0882
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE942225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist