Individual
AINSLEY VATANASOMBAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
4101 WOOLWORTH AVE, OMAHA, NE 68105-1850
(402) 346-8800
Mailing address
4115 WEST LUDWIG CIRCLE, LINCOLN, NE 68528
(515) 991-3176
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1239
NE
Other
Enumeration date
06/07/2018
Last updated
06/07/2018
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