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Organization
PINE LAKE INTENSITY-MODULATED
Active
Organization
PINE LAKE INTENSITY-MODULATED
Active
Other names
Pine Lake IMRT
Organization subpart
No
Provider details
NPI number
Authorized official
BENNETT BARRIOS MD (MANAGING MEMBER)
(402) 327-7300
Entity
Organization
Contact information
Practice address
3901 PINE LAKE RD, SUITE 111, LINCOLN, NE 68516-5497
(402) 481-6090
Mailing address
3901 PINE LAKE RD, SUITE 111, LINCOLN, NE 68516-5497
(402) 481-6090
Taxonomy
Speciality
Code
Description
License number
State
261QX0203X
Radiation Oncology Clinic/Center
Primary
—
NULL
Other
Enumeration date
01/12/2007
Last updated
12/11/2009
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