Individual
MR. CLINT ALBERT BOLLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, CRNA
Contact information
Practice address
2808 S 143RD PLZ, OMAHA, NE 68144-5611
(402) 609-1485
Mailing address
17245 COLONY DR, OMAHA, NE 68136-1403
(402) 206-1757
(507) 474-3392
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
101417
NE
Other
Enumeration date
04/16/2014
Last updated
10/04/2022
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