| NPI | 1619948551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKI MOELLENBERNDT Office Manager 402-729-3361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2010-10-12 |