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Organization

NELIGH CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRENDA KORTH-WURDINGER PA-C (OWNER/MANAGER)
(402) 887-4681
Entity
Organization

Contact information

Practice address
1108 R ST, NELIGH, NE 68756-1022
(402) 887-4681
Mailing address
1108 R ST, NELIGH, NE 68756-1022
(402) 887-4681

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
098661
MEDICARE GROUP NUMBER
NE
Enumeration date
08/24/2007
Last updated
07/21/2022
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