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Individual

ELI WHITAKER JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
11420 BLONDO ST STE 103, OMAHA, NE 68164-3858
(402) 509-5532
Mailing address
11420 BLONDO ST STE 103, OMAHA, NE 68164-3858

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
090368
IA
225100000X
Physical Therapist
Primary
3812
NE

Other

Enumeration date
04/10/2021
Last updated
04/10/2021
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