Provider First Line Business Practice Location Address:
4101 WOOLWORTH AVE.
Provider Second Line Business Practice Location Address:
VA NEBRASKA-WESTERN IOWA HEALTHCARE SYSTEM
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-995-4486
Provider Business Practice Location Address Fax Number:
402-995-4562
Provider Enumeration Date:
10/12/2006