Individual
SAMUEL ELLSWORTH MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 OLD FARM RD APT 27, LINCOLN, NE 68512-1867
(402) 417-5730
Mailing address
1400 OLD FARM RD APT 27, LINCOLN, NE 68512-1867
(402) 417-5730
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
02/11/2025
Last updated
02/11/2025
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