Individual
MR. CHAD LORAN KUDLACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR L, CHT
Contact information
Practice address
207 S BURLINGTON AVE, HASTINGS, NE 68901-5905
(402) 462-8824
(402) 462-8017
Mailing address
207 S BURLINGTON AVE, HASTINGS, NE 68901-5905
(402) 462-8824
(402) 462-8017
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
946
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36544
BLUE CROSS BLUE SHIELD
NE
Enumeration date
08/02/2006
Last updated
06/16/2010
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