| NPI | 1104061761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALVIN G WEISS President 308-882-2925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NE 1527) |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2008-12-11 |