# CONTOURBODY STRUCTURE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Valeriya Life
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801518030
- **Authorized official:** BRET VAN KETTELHUT MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (402) 253-9938

## Contact information

- **Practice address:** 1515 S 204TH ST, SUITE \#105, ELKHORN, NE 68022
- **Practice address phone:** (531) 777-2752
- **Mailing address:** 2011 S 189TH CIRCLE, OMAHA, NE 68130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/14/2022
- **Last updated:** 09/14/2022