Provider First Line Business Practice Location Address:
841 N. 14TH ST.
Provider Second Line Business Practice Location Address:
55 CAMPUS RECREATION CENTER
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68588-0232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-472-4769
Provider Business Practice Location Address Fax Number:
402-472-8080
Provider Enumeration Date:
11/01/2012