Individual
MR. JAMES DEDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1431 MAKERS ST, LINCOLN, NE 68521-3401
(402) 320-2174
Mailing address
304 RIVERVIEW ST, LESHARA, NE 68064-1514
(402) 320-2174
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41618345
—
NE
Enumeration date
12/23/2024
Last updated
12/23/2024
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