Individual
CHARLENE PECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
115 W 11TH ST, COZAD, NE 69130-1402
(308) 784-3821
Mailing address
115 W 11TH ST, COZAD, NE 69130-1402
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
G18010522
NE
Other
Enumeration date
06/20/2025
Last updated
06/20/2025
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