Individual
KYLE RYAN FORNOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
523 10TH ST, GOTHENBURG, NE 69138-1925
(308) 537-3600
(308) 537-3601
Mailing address
325 S 1ST AVE, P.O. BOX 435, BROKEN BOW, NE 68822-2213
(308) 872-5111
(308) 872-5115
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3212
NE
Other
Enumeration date
05/29/2013
Last updated
04/21/2017
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