Provider First Line Business Practice Location Address:
8200 DODGE ST
Provider Second Line Business Practice Location Address:
CHILDREN'S HOSPITAL & MEDICAL CENTER - GASTROENTEROLOGY
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68114-4113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-955-5700
Provider Business Practice Location Address Fax Number:
402-955-5720
Provider Enumeration Date:
02/27/2012