Individual
DEETT DARLA ELLWANGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1211 W 5TH ST, HASTINGS, NE 68901-4924
(402) 984-9989
Mailing address
1211 W 5TH ST, HASTINGS, NE 68901-4924
(402) 984-9989
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
12/27/2024
Last updated
12/27/2024
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