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Individual

MARK LEVI BACOME

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
5131 LEAVENWORTH ST, OMAHA, NE 68106-1343
(402) 660-5956
Mailing address
5131 LEAVENWORTH ST, OMAHA, NE 68106-1343
(402) 660-5956

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1687
NE

Other

Enumeration date
12/15/2011
Last updated
12/15/2011
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