| Dfas-jfll/in | |
|
4005 Raynor Pkwy Apt 3316 Bellevue NE 68123-6110 | |
| (210) 862-0632 | |
| Not Available |
| Full Name | Dfas-jfll/in |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 4005 Raynor Pkwy Apt 3316, Bellevue, Nebraska |
| Authorized Official Name and Position | Marina Puentes (PHYSICIAN ASSISTANT) |
| Authorized Official Contact | 2108620632 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dfas-jfll/in 4005 Raynor Pkwy Apt 3316 Bellevue NE 68123-6110 Ph: (210) 862-0632 | Dfas-jfll/in 4005 Raynor Pkwy Apt 3316 Bellevue NE 68123-6110 Ph: (210) 862-0632 |
| NPI Number | 1235539750 |
|---|---|
| Provider Enumeration Date | 09/03/2014 |
| Last Update Date | 09/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235539750 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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