Individual
DEREK J TJEPKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1702 HILLCREST DR, BELLEVUE, NE 68005-3652
(402) 682-4214
Mailing address
4707 N 176TH ST, OMAHA, NE 68116-1151
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1632
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1632
—
NE
Enumeration date
11/06/2017
Last updated
11/06/2017
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