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Organization
CONTOURBODY STRUCTURE LLC
Active
Organization
CONTOURBODY STRUCTURE LLC
Active
Other names
Valeriya Life
Organization subpart
No
Provider details
NPI number
Authorized official
BRET VAN KETTELHUT MD (MEDICAL DIRECTOR)
(402) 253-9938
Entity
Organization
Contact information
Practice address
1515 S 204TH ST, SUITE #105, ELKHORN, NE 68022
(531) 777-2752
Mailing address
2011 S 189TH CIRCLE, OMAHA, NE 68130
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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