Individual
JACK LAVALLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6029 PRATT ST, OMAHA, NE 68104-2718
(531) 346-6979
Mailing address
1299 FARNAM ST, OMAHA, NE 68102-1880
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
06/10/2026
Last updated
06/10/2026
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