Provider First Line Business Practice Location Address:
704 N 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINVIEW
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68769-2047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-582-4245
Provider Business Practice Location Address Fax Number:
402-582-3940
Provider Enumeration Date:
10/11/2006