Individual
GRANT THOMAS RIDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1625 W SNOWSHOE DR, LINCOLN, NE 68521-1695
(402) 840-2212
Mailing address
1625 W SNOWSHOE DR, LINCOLN, NE 68521-1695
(402) 840-2212
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/22/2023
Last updated
02/22/2023
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