Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 1109 9th St, Wisner, Nebraska |
Authorized Official Name and Position | Brian Monsma (EXECUTIVE NETWORK DIRECTOR) |
Authorized Official Contact | 7122792925 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 328 Sioux City IA 51102-0328 Ph: (712) 279-5830 | 1109 9th St Wisner NE 68791-2113 Ph: (402) 529-3218 |
NPI Number | 1710925813 |
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Provider Enumeration Date | 06/02/2006 |
Last Update Date | 09/27/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710925813 | NPI | - | NPPES |
100252196-00 | Medicaid | NE |