| NPI | 1114493194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS SCOTT JURACEK Owner 402-416-5687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 111N00000X Chiropractor |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2018-10-17 |