Individual
GEORGE MOUNTAIN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1309 N 206TH ST, ELKHORN, NE 68022-6935
(402) 312-1353
Mailing address
1309 N 206TH ST, ELKHORN, NE 68022-6935
(402) 312-1353
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
NE
Other
Enumeration date
12/30/2024
Last updated
12/30/2024
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