Individual
BRYNN L LASTOVICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8343 S 168TH AVE, OMAHA, NE 68136-1677
(402) 595-1227
(402) 595-1284
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27866
NE
207Q00000X
Family Medicine Physician
6476
NE
Other
Enumeration date
06/01/2011
Last updated
06/16/2017
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