| NPI | 1174951719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY JO GOSNELL President/Owner 308-520-2694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 21972) |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2022-10-20 |