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1295473734
ELLIE N WILTFONG
OMAHA, NE
NPI
1295473734
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant Medical
(Licence: NE 2759)
Enumeration Date
2022-05-24
Last Update Date
2022-05-24
Business Address
ELLIE N WILTFONG PA-C
8200 DODGE ST
OMAHA, NE 68114-4113
Phone number: 402-955-5150
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Mailing Address
ELLIE N WILTFONG PA-C
PO BOX 24607
OMAHA, NE 68124-0607
Phone number: 402-955-5400
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