Individual
KYLE ANDREW JISA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2525 S 135TH AVE, OMAHA, NE 68144-2424
(702) 899-0595
(702) 977-1496
Mailing address
PO BOX 74008272, CHICAGO, IL 60674-8272
(702) 899-0595
(702) 977-1496
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
34621
NE
Other
Enumeration date
05/17/2018
Last updated
10/02/2025
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