Individual
JODI M FABISIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1810 N 203RD ST, ELKHORN, NE 68022-2885
(402) 289-0189
Mailing address
21725 BONANZA BLVD, ELKHORN, NE 68022-1809
(402) 681-8391
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10266
NE
Other
Enumeration date
05/04/2018
Last updated
05/04/2018
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