Individual
KELLY H. HANNEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T
Contact information
Practice address
3015 S 119TH ST, OMAHA, NE 68144-4513
(402) 490-4086
Mailing address
3015 S 119TH STREET, OMAHA, NE 68144
(402) 490-4086
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
2002
NE
Other
Enumeration date
10/28/2016
Last updated
10/28/2016
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