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1154802585
JACOB TYLER MORDHORST
OMAHA, NE
NPI
1154802585
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: NE 665)
Enumeration Date
2018-08-23
Last Update Date
2018-08-23
Business Address
JACOB TYLER MORDHORST CF-SLP
3706 MAPLE ST
OMAHA, NE 68111-3195
Phone number: 402-658-1083
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Mailing Address
JACOB TYLER MORDHORST CF-SLP
3706 MAPLE ST
OMAHA, NE 68111-3195
Phone number: 402-658-1083
Copy
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