| NPI | 1083739452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVRIL LYNN CARTER Chief Front Office Facilitator 402-330-4770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: NE 15521) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2012-01-05 |