Individual
ADAM FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10462 W ST, OMAHA, NE 68127-2926
(402) 810-0473
Mailing address
9744 MOCKINGBIRD DR, OMAHA, NE 68127-2013
(402) 800-3787
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
03/27/2025
Last updated
03/27/2025
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