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Individual

DONALD JOSEPH DIVETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8005 N 166TH ST, BENNINGTON, NE 68007-2855
(505) 917-1401
Mailing address
16909 LAKESIDE HILLS PLZ STE 114, OMAHA, NE 68130-4652
(402) 932-2211

Taxonomy

Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary

Other

Enumeration date
01/16/2025
Last updated
01/16/2025
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