Provider Demographics
NPI:1689243644
Name:KLEIER, RYAN J (PT)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:J
Last Name:KLEIER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 N 205TH ST STE 140
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-4740
Mailing Address - Country:US
Mailing Address - Phone:402-289-5013
Mailing Address - Fax:402-289-5018
Practice Address - Street 1:1405 N 205TH ST STE 140
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-4740
Practice Address - Country:US
Practice Address - Phone:402-289-5013
Practice Address - Fax:402-289-5018
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4223225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist