Organization
KS OLD CHENEY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC KNOBBE (OWNER)
(402) 423-5391
Entity
Organization
Contact information
Practice address
6450 O ST STE 2, LINCOLN, NE 68510-2369
(402) 650-7333
Mailing address
6400 INDUSTRIAL LOOP, GREENDALE, WI 53129-2452
(414) 423-4100
(414) 423-4134
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/08/2018
Last updated
03/17/2018
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