Provider Demographics
NPI:1558597229
Name:GLOYSTEIN, JENNIFER M (DPT, ATC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:GLOYSTEIN
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5241 R ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-3422
Mailing Address - Country:US
Mailing Address - Phone:402-467-4545
Mailing Address - Fax:
Practice Address - Street 1:5241 R ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-3422
Practice Address - Country:US
Practice Address - Phone:402-467-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist