Provider First Line Business Practice Location Address:
8200 DODGE STREET
Provider Second Line Business Practice Location Address:
CHILDREN'S HOSPITAL - EATING DISORDERS PROGRAM
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68114-4113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-955-6190
Provider Business Practice Location Address Fax Number:
402-955-6189
Provider Enumeration Date:
03/07/2008