Professional Provider Company, Llc | |
10826 Old Mill Rd Ste 101, Omaha, NE 68154-2660 | |
(888) 840-3032 | |
(888) 840-8937 |
Full Name | Professional Provider Company, Llc |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 10826 Old Mill Rd Ste 101, Omaha, Nebraska |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1881920288 | NPI | - | NPPES |
1881920288 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
Professional Provider Company, Llc 10826 Old Mill Rd Ste 101, Omaha, NE 68154-2660 Ph: (888) 840-3032 | Professional Provider Company, Llc 10826 Old Mill Rd Ste 101, Omaha, NE 68154-2660 Ph: (888) 840-3032 |
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Dr. Matthew Luke Willis, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 4353 Dodge St, Omaha, NE 68131 Phone: 402-552-2020 Fax: 402-552-2367 | |
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