NPI 1427494632

Jacob Everett Engberg, PTA

Practitioner Physical Therapy Assistant Grand Island, NE

Practice location

Address: 3015 W Stolley Park Rd APT 95, Grand Island, NE 68801-7238
Phone: (402) 984-8614
Mailing address: 3015 W Stolley Park Rd APT 95, Grand Island, NE 68801

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 1082 (NE)

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Registry record

NPI: 1427494632
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 May 2013
Record last updated: 14 May 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.