Individual
JAY DEREK PODLISKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 S SUNSET ST LOT 8, PIERCE, NE 68767-1818
(402) 270-6794
Mailing address
501 S SUNSET ST LOT 8, PIERCE, NE 68767-1818
(402) 270-6794
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
NE
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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