Organization
PRAIRIE SURGICAL ASSOCIATES P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN R MOTA M.D. (PRESIDENT)
(402) 486-3400
Entity
Organization
Contact information
Practice address
1919 S 40TH ST, SUITE 107, LINCOLN, NE 68506-5258
(402) 486-3400
(402) 486-3344
Mailing address
1919 S 40TH ST, SUITE 107, LINCOLN, NE 68506
(402) 486-3400
(402) 486-3344
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
21192
NE
Other
Enumeration date
09/10/2007
Last updated
09/10/2007
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