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Individual

LONDON HAWK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4640 LEIGHTON AVE APT 425B, LINCOLN, NE 68504-3730
(708) 890-0708
Mailing address
5905 O ST, LINCOLN, NE 68510-2235
(708) 890-0708

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary

Other

Enumeration date
09/20/2022
Last updated
09/20/2022
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