| NPI | 1639242621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA FATTIG Office Manager 308-225-4498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: NE 21201) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2023-03-07 |