Individual
DR. BENJAMIN RANDALL GROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6751 N 72ND ST STE 105, OMAHA, NE 68122-1746
(402) 572-2020
(402) 572-2150
Mailing address
6751 N 72ND ST STE 105, OMAHA, NE 68122-1746
(402) 572-2020
(402) 572-2150
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
091798
IA
152W00000X
Optometrist
Primary
1530
NE
Other
Enumeration date
06/28/2018
Last updated
05/19/2021
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