Provider First Line Business Practice Location Address: 
2301 DAHLKE AVE
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
AUBURN
    Provider Business Practice Location Address State Name: 
NE
    Provider Business Practice Location Address Postal Code: 
68305-3024
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
402-274-4354
    Provider Business Practice Location Address Fax Number: 
402-274-4356
    Provider Enumeration Date: 
10/15/2025