Organization
PROFESSIONAL PROVIDER ENTERPRISE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ROSENBAUM (CCO)
(913) 647-7926
Entity
Organization
Contact information
Practice address
10826 OLD MILL RD STE 101, OMAHA, NE 68154-2660
(402) 898-3232
(402) 898-3234
Mailing address
10826 OLD MILL RD STE 101, OMAHA, NE 68154-2660
(888) 840-3032
(888) 270-3811
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
01891
IA
Other
Enumeration date
12/14/2011
Last updated
08/22/2025
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