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Individual

GREGORY RYAN TOLLEFSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C, ATC

Contact information

Practice address
2810 W 35TH ST, SUITE 1, KEARNEY, NE 68845-2909
(308) 865-2570
Mailing address
2810 W 35TH ST, SUITE 1, KEARNEY, NE 68845-2909
(308) 865-2570

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1644
NE

Other

Enumeration date
09/04/2007
Last updated
10/12/2016
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