Individual
JAUNETA SIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 9TH AVE, SCOTTSBLUFF, NE 69361-3222
(308) 765-3122
Mailing address
1515 9TH AVE, SCOTTSBLUFF, NE 69361-3222
(308) 765-3122
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
03/05/2025
Last updated
03/05/2025
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