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Organization

CONTOURBODY STRUCTURE LLC

Active
Other names
Valeriya Life
Organization subpart
No

Provider details

NPI number
Authorized official
BRET VAN KETTELHUT MD (MEDICAL DIRECTOR)
(402) 253-9938
Entity
Organization

Contact information

Practice address
1515 S 204TH ST, SUITE #105, ELKHORN, NE 68022
(531) 777-2752
Mailing address
2011 S 189TH CIRCLE, OMAHA, NE 68130

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary

Other

Enumeration date
09/14/2022
Last updated
09/14/2022
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