Individual
SU JI
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
17807 BURDETTE ST, OMAHA, NE 68116-2965
(531) 800-5326
Mailing address
3031 N 93RD ST, OMAHA, NE 68134-4715
(531) 800-5326
(531) 800-5326
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
01/29/2026
Last updated
01/29/2026
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