Organization
LIFESTYLES ORTHOTICS AND PROSTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIRLEY ROOF (ADM MANAGER)
(402) 393-2354
Entity
Organization
Contact information
Practice address
6940 VAN DORN ST STE 101, LINCOLN, NE 68506-2858
(402) 483-5955
(402) 483-7396
Mailing address
6751 N 72ND ST STE 201, OMAHA, NE 68122-1746
(402) 572-2233
(402) 572-2270
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0541458
—
IA
Enumeration date
05/17/2007
Last updated
08/22/2020
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