| NPI | 1205264231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY J SULLIVAN President 402-742-2502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NE 17443) |
| Enumeration Date | 2013-10-30 |
| Last Update Date | 2013-10-30 |