Individual
FRED ANTCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17931 PIERCE PLZ, OMAHA, NE 68130-2654
(402) 933-1393
(402) 933-1899
Mailing address
17931 PIERCE PLZ, OMAHA, NE 68130-2654
(402) 933-1393
(402) 933-1899
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
2255
VA
224L00000X
Pedorthist
0675
VA
225000000X
Orthotic Fitter
2255
VA
Other
Enumeration date
12/14/2010
Last updated
12/14/2010
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