Individual
AWOKI N/A ASSIH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8024 S 106TH ST, LA VISTA, NE 68128-5759
(402) 301-2830
Mailing address
8024 S 106TH ST, LA VISTA, NE 68128-5759
(402) 301-2830
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
08/21/2025
Last updated
08/21/2025
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