MEDICARE: BRIANNA TONJES PTA, LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	801	NE

General Provider Information

NPI Number	:	1154607455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA TONJES PTA, LMT

Provider Business Mailing Address
First Line	:	2081 640TH RD
Second Line	:
City	:	GORDON
State	:	NE
Zip	:	69343-5508
Country	:	US
Telephone Number	:	402-922-0359
Fax Number	:

Provider Business Practice Location Address
First Line	:	318 N 3RD ST
Second Line	:
City	:	HAY SPRINGS
State	:	NE
Zip	:	69347-1107
Country	:	US
Telephone Number	:	308-638-4483
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2011
Last Update Date	:	12/22/2021

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