Individual
MR. MIKE MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2420 W OMAHA AVE, NORFOLK, NE 68701-1526
(712) 276-9000
Mailing address
2420 W OMAHA AVE, NORFOLK, NE 68701-1526
(712) 276-9000
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
11763
NE
Other
Enumeration date
03/08/2019
Last updated
03/08/2019
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