Individual
DONTAE SALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2505 N 24TH ST, OMAHA, NE 68110-2252
(402) 451-5549
(402) 502-0687
Mailing address
2505 N 24TH ST, OMAHA, NE 68110-2252
(402) 451-5549
(402) 502-0687
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/11/2017
Last updated
08/11/2017
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