Individual
POE REH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7804 MORRIS ST, OMAHA, NE 68122-2047
(402) 708-0533
Mailing address
7804 MORRIS ST, OMAHA, NE 68122-2047
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
11/19/2025
Last updated
11/19/2025
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