Organization
D.B.A MOM'S MASTECTOMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JENNIFER LYNN HAWKINS (OWNER)
(402) 464-6001
Entity
Organization
Contact information
Practice address
415 N 66TH ST, SUITE 8, LINCOLN, NE 68505-2431
(402) 464-6001
(402) 464-6669
Mailing address
415 N 66TH ST., SUITE 8, LINCOLN, NE 68505
(402) 464-6001
(402) 464-6669
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
NE
Other
Enumeration date
10/07/2008
Last updated
01/26/2010
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