Provider First Line Business Practice Location Address:
4075 EAST CAMPUS LOOP S
Provider Second Line Business Practice Location Address:
203A BARKLEY MEMORIAL CENTER
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68583-0731
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-472-2071
Provider Business Practice Location Address Fax Number:
402-472-3814
Provider Enumeration Date:
08/05/2016