Provider First Line Business Practice Location Address:
PO BOX 156
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAUSA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68786-0156
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-841-7750
Provider Business Practice Location Address Fax Number:
402-841-7750
Provider Enumeration Date:
04/28/2025