| NPI | 1366543365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFFORD R. COLGLAZIER Owner 308-352-2122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NE 14390) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2008-05-28 |