Individual
ELPIDIONESTOR TABUTOL ILORETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
908 N HOWARD AVE, STE 108, GRAND ISLAND, NE 68803-3556
(308) 381-2224
(308) 381-0793
Mailing address
908 N HOWARD AVE, STE 108, GRAND ISLAND, NE 68803-3556
(308) 381-2224
(308) 381-0793
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20908
NE
Other
Enumeration date
02/27/2006
Last updated
12/15/2021
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