Individual
KYLE ROBERT GOODBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5000 SAINT PAUL AVE, LINCOLN, NE 68504-2760
(402) 465-7508
Mailing address
10150 N 150TH ST, WAVERLY, NE 68462-1595
(402) 405-2145
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/02/2022
Last updated
03/02/2022
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