- Practice location
- 9394 W Dodge RD Ste 300, Omaha, NE 68114-3319
- Phone
- 800-732-3784
- Fax
- —
- Last updated
- May 18, 2023
Spencer Andrew Bourassa is a Physical Therapist based in Omaha, NE. Spencer Andrew Bourassa practices in Omaha, NE and has the professional credentials of PT, DPT. The NPI Number for Spencer Andrew Bourassa is 1770209702 and holds a License No. PT39406 (FL). The current practice location address for Spencer Andrew Bourassa is 9394 W Dodge RD Ste 300, Omaha, NE 68114-3319 and can be reached out via phone at 800-732-3784.
Provider Profile Details
- NPI Number
- 1770209702
- Provider Name
- Spencer Andrew Bourassa
- Credential
- PT, DPT
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 9394 W Dodge RD Ste 300, Omaha, NE 68114-3319
- Phone Number
- 800-732-3784
- Primary Taxonomy
- Physical Therapist · 225100000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- October 12, 2022
- Last Update Date
- May 18, 2023
- Certification Date
- May 18, 2023
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 9394 W Dodge RD Ste 300
Omaha, NE 68114-3319 - City
- Omaha
- State
- Nebraska
- Zip
- 68114-3319
- Phone Number
- 800-732-3784
Provider Business Mailing Address Details
- Address
- 84 Rustic Ln
Lyman, ME 04002-6042 - City
- Lyman
- State
- ME
- Zip
- 04002-6042
- Phone Number
- 207-590-9179
License Information
- License Number (1)
- PT39406
- License State (1)
- FL
- Taxonomy (1)
- Physical Therapist · 225100000X
- License Number (2)
- 26806
- License State (2)
- MA
- Taxonomy (2)
- Physical Therapist · 225100000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Physical Therapists near Omaha, NE
View all Physical Therapists in Omaha →Frequently Asked Questions
What is the NPI number of Dr. Spencer A Bourassa, PT, DPT?
The NPI number of Dr. Spencer A Bourassa, PT, DPT is 1770209702. It was assigned on October 12, 2022 and is currently active in the NPPES registry.
What is the specialty of Dr. Spencer A Bourassa, PT, DPT?
Dr. Spencer A Bourassa, PT, DPT is registered under the primary taxonomy Physical Therapist (code 225100000X), licensed in FL under license number PT39406.
Where does Dr. Spencer A Bourassa, PT, DPT practice?
The practice location is 9394 W Dodge RD Ste 300, Omaha, NE 68114-3319. The office can be reached at 800-732-3784 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1770209702 directly on the NPPES registry website.