Provider First Line Business Practice Location Address:
120 SOUTH 9TH STREET
Provider Second Line Business Practice Location Address:
COTTONWOOD CLINIC
Provider Business Practice Location Address City Name:
TEKAMAH
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68061-1487
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-374-1585
Provider Business Practice Location Address Fax Number:
402-374-1612
Provider Enumeration Date:
08/30/2006