Healthcare Provider Details

I. General information

NPI: 1306564349
Provider Name (Legal Business Name): LANDON ZARYBNICKY DPT, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2022
Last Update Date: 08/16/2022
Certification Date: 08/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JEFFERSON COMMUNITY HEALTH & LIFE 2200 H STREET
FAIRBURY NE
68352-6835
US

IV. Provider business mailing address

JEFFERSON COMMUNITY HEALTH & LIFE 2200 H STREET
FAIRBURY NE
68352
US

V. Phone/Fax

Practice location:
  • Phone: 402-729-6840
  • Fax:
Mailing address:
  • Phone: 402-729-6840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4385
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: