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Individual

PRESTON CC RENSHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
300 N 2ND ST, STE 100, ONEILL, NE 68763-1519
(402) 336-2900
Mailing address
PO BOX 270, ONEILL, NE 68763-0270
(402) 336-2900

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22884
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025621600
NE
Enumeration date
05/23/2006
Last updated
01/06/2014
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