Provider First Line Business Practice Location Address:
984180 NEBRASKA MEDICAL CTR
Provider Second Line Business Practice Location Address:
EMILE AT 42ND ST.
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68198-4180
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-559-4364
Provider Business Practice Location Address Fax Number:
402-559-9107
Provider Enumeration Date:
06/09/2006