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1104485168
SHANNA LEA POGUE
OMAHA, NE
NPI
1104485168
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: NE NE151)
Enumeration Date
2019-06-12
Last Update Date
2019-06-12
Business Address
Mrs. SHANNA LEA POGUE PTA
4330 S 144TH ST
OMAHA, NE 68137-1051
Phone number: 402-614-4000
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Mailing Address
Mrs. SHANNA LEA POGUE PTA
19156 W ST
OMAHA, NE 68135-4298
Phone number: 402-203-7743
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