Healthcare Provider Details

I. General information

NPI: 1679708523
Provider Name (Legal Business Name): RYAN F. GALLAGHER DPT, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2009
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 JAMES ST
VERDIGRE NE
68783-6149
US

IV. Provider business mailing address

PO BOX 633
CREIGHTON NE
68729-0633
US

V. Phone/Fax

Practice location:
  • Phone: 402-668-2231
  • Fax:
Mailing address:
  • Phone: 402-358-3339
  • Fax: 402-358-3375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2746
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: