Individual
ETHEL REALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7350 GRACELAND DR, OMAHA, NE 68134-4328
(402) 557-6631
Mailing address
4607 N 126TH AVE, OMAHA, NE 68164-6900
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1380
NE
Other
Enumeration date
06/26/2007
Last updated
07/08/2007
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