Individual
EICHELLE DE LOS SANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
311 W 31ST ST, SCOTTSBLUFF, NE 69361-4380
(308) 631-8164
Mailing address
311 W 31ST ST, SCOTTSBLUFF, NE 69361-4380
(308) 631-8164
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
H12862427
NE
Other
Enumeration date
01/14/2025
Last updated
01/14/2025
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