DYNAMIC LIFE THERAPY AND WELLNESS PC NPI 1083945554

NPI Information

  • NPI: 1083945554
  • Provider Name: DYNAMIC LIFE THERAPY AND WELLNESS PC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Address: 3763 39TH AVE
    SUITE 100
    COLUMBUS, NE
    ZIP 68601
  • Phone: (402) 606-4492

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NPI Details

DYNAMIC LIFE THERAPY AND WELLNESS PC is a clinic center in Columbus, NE. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). DYNAMIC LIFE THERAPY AND WELLNESS PC NPI is 1083945554. The provider is registered as an organization entity type.

The provider's business location address is:

3763 39TH AVE
SUITE 100
COLUMBUS, NE
ZIP 68601-504
Phone: (402) 606-4492
Fax: (402) 615-4168

The provider's authorized official is Sharee Jo Fejfar-jedlicka .
The authorized official title is President/owner and has the following contact phone number (402) 606-4492.

The enumeration date for this NPI number is 1/23/2010 and was last updated on 6/3/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/Center1752NEBRASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
110025818800MEDICAIDNEBRASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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