Individual
SHANE ISOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EMT
Contact information
Practice address
PO BOX 158, PAGE, NE 68766-0158
(402) 338-5901
Mailing address
49660 872ND RD, ONEILL, NE 68763-5306
(402) 340-0892
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
21208
NE
Other
Enumeration date
02/07/2025
Last updated
02/07/2025
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