Individual
MR. GARY LEE ANDERSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AAS, PLADC
Contact information
Practice address
11215 JOHN GALT BLVD, OMAHA, NE 68137-2319
(402) 592-5900
(402) 592-5901
Mailing address
11215 JOHN GALT BLVD, OMAHA, NE 68137-2319
(402) 592-5900
(402) 592-5901
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
P1502
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073874731
—
NE
Enumeration date
01/10/2022
Last updated
01/10/2022
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