| NPI | 1669243887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS WAGNER Registered Agent 402-401-6243 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine |
| Enumeration Date | 2024-01-16 |
| Last Update Date | 2024-01-16 |