Individual
JESSE WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 DAHLBERG DR STE E, LINCOLN, NE 68512-9217
(402) 423-8119
Mailing address
1400 DAHLBERG DR STE E, LINCOLN, NE 68512-9217
(402) 423-8119
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
1710500525
NE
Other
Enumeration date
03/16/2026
Last updated
03/16/2026
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