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1194432104
LANA RAQUEL GOFORTH
OMAHA, NE
NPI
1194432104
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: NE 2735)
Enumeration Date
2022-10-31
Last Update Date
2022-10-31
Business Address
LANA RAQUEL GOFORTH OTD OTR/L
2824 N 66TH AVE
OMAHA, NE 68104-3928
Phone number: 402-551-2110
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Mailing Address
LANA RAQUEL GOFORTH OTD OTR/L
19631 T ST
OMAHA, NE 68135-4315
Phone number: 402-810-2905
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