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NPI Code Detail

MEDICARE: MS. SHAREE JO FEJFAR-JEDLICKA PT, DPT

MEDICARE:  MS. SHAREE JO FEJFAR-JEDLICKA  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 Therapist1752NE

General Provider Information

NPI Number : 1538494034
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHAREE JO FEJFAR-JEDLICKA PT, DPT
Provider Business Mailing Address
First Line : 3763 39TH AVE
Second Line : SUITE #100
City : COLUMBUS
State : NE
Zip : 68601-4504
Country : US
Telephone Number : 402-615-0183
Fax Number :
Provider Business Practice Location Address
First Line : 3763 39TH AVE
Second Line : SUITE #100
City : COLUMBUS
State : NE
Zip : 68601-4504
Country : US
Telephone Number : 402-615-0183
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2009
Last Update Date : 10/16/2009

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Directions to “ MS. SHAREE JO FEJFAR-JEDLICKA PT, DPT” Practice Location

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