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Active's Lien Process //

Active Spine Physical Therapy requires the following forms be completed in their entirety prior to scheduling any appointments for the patient. We also encourage submission of the police report.

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Fax the completed forms to 402-206-2768.

Nicholas Muchowicz & Erik Gapp @

120th and Miracle Hills:

11810 Nicholas Street, Suite 103

Omaha, NE 68154

© 2019 Active Spine Physical Therapy, LLC

To Schedule An Appointment

Call 402.932.2888

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Jay Herman @

79th and Dodge:

7919 Wakeley Plaza

Omaha, NE 68114

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