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General NPI Number Information
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NPI Number | 1760590798
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Entity Type | Individual
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Provider Name | JON D STOLTENBERG MPT
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Gender | Male
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 555 S 70TH ST RM 2504
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City | LINCOLN
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State | NE
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Zip | 68510-2462
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Country | US
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Telephone | 402-219-7498
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Fax |
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Provider Business Mailing Address
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Address Line | 8055 O ST STE 300
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City | LINCOLN
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State | NE
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Zip | 68510-2580
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Country | US
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Telephone | 402-421-0896
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Fax | 402-421-0945
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 1812
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License Number State | NE
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