Individual
SHANNON FAVELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13831 CHALCO VALLEY PKWY, SUITE 101, OMAHA, NE 68138-6101
(402) 592-5244
Mailing address
13831 CHALCO VALLEY PKWY, SUITE 101, OMAHA, NE 68138-6101
(402) 592-5244
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
2398
NE
Other
Enumeration date
08/05/2013
Last updated
08/05/2013
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