| NPI | 1740599893 |
|---|---|
| Doing Business As | PREVENTATIVE MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | JUSTIN M KOHLL Owner 402-108-0012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2011-01-12 |