Provider Demographics
NPI:1376218891
Name:LEFEBER, RYAN JEFFRY
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:JEFFRY
Last Name:LEFEBER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 4TH ST
Mailing Address - Street 2:
Mailing Address - City:NEOLA
Mailing Address - State:IA
Mailing Address - Zip Code:51559-3050
Mailing Address - Country:US
Mailing Address - Phone:402-880-0526
Mailing Address - Fax:
Practice Address - Street 1:500 4TH ST
Practice Address - Street 2:
Practice Address - City:NEOLA
Practice Address - State:IA
Practice Address - Zip Code:51559-3050
Practice Address - Country:US
Practice Address - Phone:402-880-0526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA107698225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant