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Individual

JOHNNY B WALKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
11340 BLONDO ST, OMAHA, NE 68164-3815
(402) 889-5686
Mailing address
6258 S 36TH AVE, OMAHA, NE 68107-3824
(402) 718-6359

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary

Other

Enumeration date
03/05/2025
Last updated
03/05/2025
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