Provider First Line Business Practice Location Address:
116 S LINCOLN AVE
Provider Second Line Business Practice Location Address:
#2
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68467-4240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-362-1888
Provider Business Practice Location Address Fax Number:
402-362-1888
Provider Enumeration Date:
10/08/2013