| NPI | 1932201803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD E MATZKE Owner 308-537-7131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: NE 16542) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2012-04-30 |