Individual
SAMUEL LARKING RAYBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2207 OSBORNE DR W STE 100, HASTINGS, NE 68901-9111
(402) 462-2139
Mailing address
2207 OSBORNE DR W STE 100, HASTINGS, NE 68901-9111
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2335
NE
Other
Enumeration date
03/13/2019
Last updated
03/13/2019
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