| NPI | 1700991510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN SCOT MAHNKE Corporate Officer 308-946-3845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 261QR1300X Clinic/Center, Rural Health | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2012-11-26 |