Provider First Line Business Practice Location Address:
1800 SYRACUSE AVENUE
Provider Second Line Business Practice Location Address:
PONCA HILLS HEALTH AND WELLNESS CENTER
Provider Business Practice Location Address City Name:
NOROFLK
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-371-8780
Provider Business Practice Location Address Fax Number:
402-371-4094
Provider Enumeration Date:
03/01/2007