Organization
NORTHWOODS SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN TENNITY D.P.M. (MEMBER)
(402) 483-4485
Entity
Organization
Contact information
Practice address
1150 N 83RD ST, LINCOLN, NE 68505-2080
(402) 483-4485
Mailing address
7441 O ST, SUITE 201, LINCOLN, NE 68510-2468
(402) 483-4485
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35516
BCBS OF NEBRASKA
NE
Enumeration date
05/19/2006
Last updated
02/22/2008
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