Provider First Line Business Practice Location Address:
400 PEBBLE ST
Provider Second Line Business Practice Location Address:
PO BOX L
Provider Business Practice Location Address City Name:
SCRIBNER
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68057-3006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-664-2568
Provider Business Practice Location Address Fax Number:
402-664-2708
Provider Enumeration Date:
10/23/2015