Organization
FREMONT PEDIATRIC, ADOLESCENT AND YOUNG ADULT MEDICINE, LLC.
Active
Other names
Kid Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY N WOOLDRIDGE MD (OWNER)
(402) 727-5500
Entity
Organization
Contact information
Practice address
220 E 22ND ST, FREMONT, NE 68025-2606
(402) 727-5500
(402) 727-6047
Mailing address
220 E 22ND ST, FREMONT, NE 68025-2606
(402) 727-5500
(402) 727-6047
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
18159
NE
Other
Enumeration date
10/17/2007
Last updated
08/01/2014
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