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NPI Code Detail

MEDICARE: KALA PREISTER PT, DPT

MEDICARE: KALA PREISTER PT, DPT
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
1225100000XPhysical Therapist3378NE

General Provider Information

NPI Number : 1326457730
Entity Type Code : Individual
Provider Name (Legal Business Name) : KALA PREISTER PT, DPT
Provider Business Mailing Address
First Line : 45828 535TH AVENUE
Second Line :
City : NEWMAN GROVE
State : NE
Zip : 68758
Country : US
Telephone Number : 712-269-9887
Fax Number :
Provider Business Practice Location Address
First Line : 706 EWING ST
Second Line :
City : GENOA
State : NE
Zip : 68640-3035
Country : US
Telephone Number : 402-993-4599
Fax Number : 402-993-2373
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2014
Last Update Date : 09/21/2017

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Directions to “ KALA PREISTER PT, DPT” Practice Location

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