| NPI | 1366406928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD J JIROVEC Owner 402-423-1382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NE 17216) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NE 356) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2011-01-20 |