| NPI | 1467858415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY DARYL RODGERS Owner/Medical Director 308-224-2131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: NE 16658) |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2014-11-18 |