Healthcare Provider Details
I. General information
NPI: 1235056185
Provider Name (Legal Business Name): MR. RICKY JIM SALSMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4 WESTVIEW DR
GRANT NE
69140-3112
US
IV. Provider business mailing address
PO BOX 579
GRANT NE
69140-0579
US
V. Phone/Fax
- Phone: 308-352-6929
- Fax:
- Phone: 308-352-6929
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 172A00000X |
| Taxonomy | Driver |
| License Number | G74001576 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: